S.C. Medicina Legale U, A.O.U. Città della Salute e della Scienza di Torino, Corso Bramante 88/90, 10126, Torino, Italy.
Institute of Legal Medicine and Forensic Sciences, University Medical Centre Charité, University of Berlin, Turmstr. 21, Building N, 10559, Berlin, Germany.
Forensic Sci Med Pathol. 2020 Sep;16(3):528-530. doi: 10.1007/s12024-020-00222-7. Epub 2020 Feb 27.
Fatal gas embolism in hospital is usually an iatrogenic complication of invasive diagnostic and therapeutic procedures. Air or gas enters the venous circulation, leading to cardiovascular failure or migrating to the systemic arterial circulation. A 73-year-old man died suddenly in hospital. An allergic reaction was initially suspected because of the presence of soft tissue swelling, but it was noticed that his oxygen tube was attached to the indwelling catheter inserted in the patient's right median cubital vein. Whole-body post-mortem multi-slice computed tomography (pm-MSCT) revealed abundant gas in the subcutaneous fatty tissue, in the heart chambers, in the mediastinum, pericardium, thoracic wall and peritoneum. The external examination revealed massive subcutaneous emphysema with marked palpable cutaneous tension and crepitation on palpation of the entire body's surface. Autopsy found gas bubbles in the heart and throughout the vascular system. Death was attributed to cardiac gas embolism.
医院内的致死性气体栓塞通常是有创性诊断和治疗程序的医源性并发症。空气或气体进入静脉循环，导致心血管衰竭或迁移到体循环动脉。一名 73 岁男子在医院突然死亡。最初怀疑是过敏反应，因为存在软组织肿胀，但注意到他的氧气管连接到插入患者右肘正中静脉的留置导管上。全身死后多层螺旋 CT（pm-MSCT）显示皮下脂肪组织、心腔、纵隔、心包、胸壁和腹膜中有大量气体。外部检查显示广泛的皮下气肿，整个身体表面有明显可触及的皮肤张力和捻发音。尸检发现心脏和整个血管系统中有气泡。死因被认为是心脏气体栓塞。
