Takahashi Yoichiro, Sano Rie, Yasuda Akiyuki, Kuboya Eri, Takahashi Keiko, Kubo Rieko, Kominato Yoshihiko, Takei Hiroyuki, Kobayashi Susumu, Shimada Takehiro, Awata Sachiko, Tokue Hiroyuki, Hirasawa Satoshi
Department of Legal Medicine, Gunma University, Graduate School of Medicine, Maebashi 371-8511, Japan; Lieber Institute for Brain Development, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
Department of Legal Medicine, Gunma University, Graduate School of Medicine, Maebashi 371-8511, Japan.
Leg Med (Tokyo). 2017 Jul;27:1-4. doi: 10.1016/j.legalmed.2017.05.004. Epub 2017 May 26.
An 84-year-old man who had suffered from chronic obstructive pulmonary disease accompanied by moderate pneumonia as well as gastric cancer with liver metastasis was found dead by a nurse, who noticed that the patient's intravenous catheter in the left forearm had been erroneously connected to an oxygen supply in his hospital room, leading to infusion of oxygen into a vein. Postmortem CT scanning demonstrated multiple accumulations of gas in the pulmonary artery, the right atrium and ventricle, as well as the left subclavian and brachiocephalic veins, corresponding to the route that the infused gas would have taken to the heart and pulmonary artery. Conventional autopsy revealed the presence of gas in the right ventricle. These findings suggested that the immediate cause of death was a gas embolus due to oxygen that had entered the cardiopulmonary circulation via the intravenous catheter. This case highlights the usefulness of postmortem imaging as an aid to conventional autopsy for demonstrating gas embolism.
一名84岁男性，患有慢性阻塞性肺疾病并伴有中度肺炎以及伴有肝转移的胃癌，被护士发现死亡。护士注意到患者左前臂的静脉导管被错误地连接到了病房的氧气供应源，导致氧气输入静脉。尸检CT扫描显示肺动脉、右心房和心室以及左锁骨下静脉和头臂静脉中有多处气体积聚，与注入的气体进入心脏和肺动脉的路径相符。传统尸检发现右心室内有气体。这些发现表明，直接死因是通过静脉导管进入心肺循环的氧气导致的气体栓塞。该病例突出了尸检成像作为辅助传统尸检以证明气体栓塞的有用性。
