Singh Mansharan Kaur Chainchel, O'Donnell Christopher, Woodford Noel William
Faculty of Medicine, Universiti Teknologi Mara (UiTM), Level 20, S&T Tower 1, 40450 Shah Alam, Selangor, Malaysia.
Forensic Sci Med Pathol. 2009;5(3):236-42. doi: 10.1007/s12024-009-9103-y. Epub 2009 Aug 11.
We report the case of an 82-year-old woman with a past history of diabetes mellitus who died following blunt head injury sustained in a fall resulting in an acute subdural hematoma. Serial postmortem CT scans of the chest and abdomen performed over a 3-day period demonstrated progressive intra-hepatic and intra-cardiac gas formation whilst the deceased was stored in a standard mortuary refrigerator at a nominated temperature of 4 degrees C. Measured mortuary refrigerator temperatures over a 7 day period showed statistically significant day to day variability in temperatures above 4 degrees C as well as variations in temperature depending on location within the refrigerator space. In the absence of other known factors associated with such gas formation, putrefaction seems the likely cause despite a lack of obvious external features. This phenomenon must therefore be taken into account when interpreting the presence of visceral gas on postmortem CT and relating such gas to the cause of death.
我们报告了一例82岁女性病例，该患者有糖尿病病史，因跌倒导致钝性头部损伤，继发急性硬膜下血肿后死亡。在3天时间内对胸部和腹部进行的系列尸检CT扫描显示，在死者被存放在标准停尸房冰箱中、指定温度为4摄氏度的情况下，肝内和心内气体逐渐形成。在7天时间内测量的停尸房冰箱温度显示，4摄氏度以上的温度存在统计学上显著的每日变化，以及取决于冰箱空间内位置的温度变化。在没有其他与此类气体形成相关的已知因素的情况下，尽管缺乏明显的外部特征，但腐败似乎是可能的原因。因此，在解释尸检CT上内脏气体的存在并将此类气体与死因相关联时，必须考虑到这一现象。
