Baumeister Rilana, Thali Michael Josef
Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, Zurich CH-8057, Switzerland.
Radiol Case Rep. 2020 Jul 11;15(9):1618-1622. doi: 10.1016/j.radcr.2020.07.002. eCollection 2020 Sep.
The objective of this case report is the visualization and assessment of ingested or inserted foreign bodies by postmortem computed tomography and autopsy. The presence of foreign objects in the gastrointestinal tract involves, among many other medical subdisciplines, the fields of forensic medicine and psychiatry. We present a case of an 18-year-old female Caucasian with borderline personality disorder who was found unconscious in a closed psychiatric ward with suspected ingested foreign bodies. Cardiopulmonary resuscitation was unsuccessful. Postmortem computed tomography revealed several sharp foreign bodies in the intestine varying in radiodensity and shape but not perforating any anatomic structures. The autopsy showed well-preserved tablets in the intestine, a few inserted glass fragments and one metal fragment. Ultimately, fatal intoxication involving a mixture of opioids, benzodiazepines, neuroleptics and antidepressants resulted. This case illustrates the potential contribution of postmortem computed tomography in diagnosing, localizing and defining ingested and inserted foreign bodies in deceased as well as living individuals. Thus, diagnostic imaging might increase safety not only for the affected individuals but also for medical staff.
本病例报告的目的是通过死后计算机断层扫描和尸检对摄入或插入的异物进行可视化和评估。胃肠道中存在异物涉及多个医学子学科,包括法医学和精神病学领域。我们报告一例18岁患有边缘性人格障碍的白种女性病例,她在封闭的精神科病房被发现昏迷,怀疑摄入了异物。心肺复苏未成功。死后计算机断层扫描显示肠道内有几个尖锐的异物,其放射密度和形状各异,但未穿透任何解剖结构。尸检显示肠道内有保存完好的药片、一些插入的玻璃碎片和一块金属碎片。最终,导致了涉及阿片类药物、苯二氮䓬类药物、抗精神病药物和抗抑郁药物混合物的致命中毒。该病例说明了死后计算机断层扫描在诊断、定位和确定死者及生者摄入和插入的异物方面的潜在作用。因此,诊断成像不仅可能提高受影响个体的安全性,也可能提高医务人员的安全性。