Chmieliauskas Sigitas, Mundinas Eimantas, Fomin Dmitrij, Andriuskeviciute Gerda, Laima Sigitas, Jurolaic Eleonora, Stasiuniene Jurgita, Jasulaitis Algimantas
Department of Pathology, Forensic Medicine and Pharmacology, Institute of Biomedical Sciences of the Faculty of Medicine of Vilnius University, Vilnius. State Forensic Medicine Service, Vilnius, Lithuania.
Medicine (Baltimore). 2018 Jun;97(24):e11041. doi: 10.1097/MD.0000000000011041.
Positional asphyxia is a rare cause of sudden death and a difficult diagnosis, based mostly on the circumstances of the incident, along with particular external and internal findings, frequent in asphyxia (signs of sudden death).
In this report, we are describing one case of adult who was found positioned in a way that led to eventual asphyxiation.
The final diagnosis of positional asphyxia was determined after the autopsy.
In a head-down position, gravitation and mechanical forces lead to an increased pressure on the diaphragm from the weight of the abdominal organs. Abdominal breathing, and later, chest breathing were hindered by the raised diaphragm and the difference between abdominal and breathing pressures.
It is known that death from positional asphyxia can emerge in several ways, such as the external breathing suppression when the victim's torso is compressed or deformed.
Therefore, the current criteria for positional asphyxia are based on the obstruction of normal gas exchange caused by the body position, the impossibility to move to another position, and the exclusion of other causes of death. The forensic medical examination must also be started at the scene of the incident.
体位性窒息是猝死的罕见原因，诊断困难，主要基于事件发生的情况，以及窒息（猝死迹象）中常见的特定外部和内部发现。
在本报告中，我们描述了一例成年患者，其被发现处于最终导致窒息的体位。
尸检后确定为体位性窒息的最终诊断。
在头低体位时，重力和机械力会导致腹部器官重量对膈肌的压力增加。抬高的膈肌以及腹部与呼吸压力之间的差异阻碍了腹式呼吸，随后也阻碍了胸式呼吸。
众所周知，体位性窒息导致的死亡可通过多种方式出现，例如受害者躯干受压或变形时的外部呼吸抑制。
因此，当前体位性窒息的标准基于身体姿势导致的正常气体交换受阻、无法移动到其他体位以及排除其他死亡原因。法医检查也必须在事件现场开始。
