Tse Rexson, Garland Jack, Triggs Yvonne, Stables Simon
From the *Department of Forensic Pathology, LabPLUS, Auckland City Hospital, Auckland, New Zealand; and †Hornsby Ku-Ring-Gai Hospital, Hornsby, New South Wales, Australia.
Am J Forensic Med Pathol. 2018 Mar;39(1):50-53. doi: 10.1097/PAF.0000000000000362.
Nontraumatic hemopericardium is a potentially fatal pathology that is most commonly caused by myocardial wall rupture, ruptured aortic dissection, aortic aneurysm rupture, or a neoplastic process. A rare potential cause of hemopericardium is pulmonary artery dissection, with less than 100 reported cases in the literature. Pulmonary artery dissection is associated with pulmonary artery aneurysm, pulmonary artery hypertension, and congenital heart disease. We report a fatal case of nontraumatic hemopericardium caused by a ruptured dissecting pulmonary artery aneurysm in a 16-year-old girl with patent ductus arteriosus. The unenhanced postmortem computed tomography performed before autopsy was able to identify a large hemopericardium with a pulmonary artery aneurysm and lifting of mural calcification suggestive of a dissecting aneurysm. This enabled the pathologist to locate the exact rupture site that caused the hemopericardium.
非创伤性心包积血是一种潜在致命性病变，最常见的病因是心肌壁破裂、主动脉夹层破裂、主动脉瘤破裂或肿瘤性病变。肺动脉夹层是心包积血的一种罕见潜在病因，文献报道病例少于100例。肺动脉夹层与肺动脉瘤、肺动脉高压和先天性心脏病有关。我们报告一例16岁动脉导管未闭女孩因肺动脉夹层动脉瘤破裂导致非创伤性心包积血死亡的病例。尸检前进行的非增强计算机断层扫描能够识别出大量心包积血、肺动脉瘤以及提示夹层动脉瘤的壁层钙化移位。这使病理学家能够确定导致心包积血的确切破裂部位。
