Department of Legal Medicine, Graduate School of Medicine, Chiba University, Inohana 1-8-1,Chiba City, Chiba Prefecture 260-8670, Japan.
Forensic Sci Int. 2013 Sep 10;231(1-3):e4-10. doi: 10.1016/j.forsciint.2013.06.001. Epub 2013 Jun 24.
We present a case of unusual gas embolism in a 73-year-old man who was found in a state of cardiopulmonary arrest with an oxygen-supply tube connected to an intravenous catheter inserted into his median cubital vein. Postmortem computed tomography (PMCT) performed 27 h after death showed systemic gas distribution including intravascular gas, pneumothorax, pneumoperitoneum, pneumomediastinum, pneumoretroperitoneum and gastric emphysema. A second PMCT scan performed 116 h after death showed a marked decrease of air inside the body. The current case shows the importance of PMCT for visualization, quantification, and preservation of evidence for establishment of the cause of death in cases with suspected gas embolism. Our findings also indicate that performance of two PMCT examinations may be useful for differentiation of embolized gas from gas produced by putrefaction.
我们报告了一例 73 岁男性患者的罕见气体栓塞病例，该患者被发现处于心肺骤停状态，一根供氧管连接到插入其正中尺侧静脉的静脉导管。死亡后 27 小时进行的死后计算机断层扫描（PMCT）显示全身气体分布，包括血管内气体、气胸、气腹、纵隔气肿、腹膜后气肿和胃积气。死亡后 116 小时进行的第二次 PMCT 扫描显示体内空气明显减少。本病例表明 PMCT 对于可视化、量化和保存疑似气体栓塞病例死因的证据非常重要。我们的发现还表明，进行两次 PMCT 检查可能有助于区分栓塞气体和腐败产生的气体。
