Sowell Matthew W, Lovelady Cari L, Brogdon B G, Wecht Cyril H
Department of Radiology, University of South Alabama Medical Center, Mobile, AL, USA.
J Forensic Sci. 2007 Jan;52(1):183-8. doi: 10.1111/j.1556-4029.2006.00307.x.
An otherwise healthy male infant was brought to the hospital because the mother suspected superficial infection at the operative site 5 days after an inguinal hernia repair. He was admitted to the pediatric unit overnight to be evaluated by his surgeon the next morning. When a venous infusion of maintenance fluids was started, the patient immediately went into cardio-respiratory arrest and was pronounced dead after resuscitation efforts failed. Subsequently, air collections were found in both venous and arterial circulations, including the splenoportal system. Detailed review of the clinical presentation and course, laboratory results, radiological, and pathological findings, along with a review of pertinent literature provides an explanation for the death by air embolism. Apparent inconsistent findings both radiographically and at autopsy are resolved. The mechanism of distribution of air to both systemic and splenoportal circulation is discussed. We believe this to be only the eighth case reported in English-language literature of infantile death from peripheral venous infusion. In all age groups, we find only six other cases in the English-language literature of gas found concomitantly in both the systemic and portal venous systems.
一名原本健康的男婴因母亲怀疑其在腹股沟疝修补术后5天手术部位存在浅表感染而被送往医院。他被收治到儿科病房过夜，以便第二天早上由外科医生进行评估。当开始静脉输注维持液时，患儿立即发生心肺骤停，经抢救无效后被宣布死亡。随后，在静脉和动脉循环中均发现了气体聚集，包括脾门静脉系统。对临床表现和病程、实验室检查结果、影像学和病理学发现进行详细回顾，并查阅相关文献，为空气栓塞导致的死亡提供了解释。影像学和尸检中明显不一致的发现得到了解决。讨论了空气进入体循环和脾门静脉循环的机制。我们认为这是英文文献中报道的第八例因外周静脉输注导致婴儿死亡的病例。在所有年龄组中，我们在英文文献中仅发现另外六例在体循环和门静脉系统中同时发现气体的病例。
