Poulain C, Prigent T, Guibourg B, Le Flahec G, Martin E, Salem D Ben
Department of Forensic Medicine, Brest University Hospital, Boulevard Tanguy-Prigent, Brest cedex, 29609, France.
Medicolegal private practice, Saint Martin des Champs, France.
Forensic Sci Med Pathol. 2025 Jan 27. doi: 10.1007/s12024-025-00952-6.
Pneumopericardium (PPC) is defined by the presence of gas in the pericardial cavity, often leading to cardiac tamponade and a high mortality rate. This report describes a case involving a 33-year-old man found deceased a few meters from a knife, his clothes intact, with no resuscitation attempt made. A knotted scarf was tightly fastened around his neck, without ligature mark. Post-mortem CT revealed 271 ml of gas in the pericardial cavity, with "flattened heart". The forensic examination revealed two thoracic stab wounds, one penetrated the pericardium without penetrating the heart chamber, while the second remained superficial. In the absence of resuscitation or exsanguination, and in the presence of some non-specific signs observed in the context of asphyxia, the hypothesis of death by compressive PPC was supported. This first French case report of PPC highlights the rarity of this entity in forensic settings, and comparison with other cases described in the literature which did not present the same characteristics points out the diagnostic difficulties it presents and the importance of post-mortem CT in diagnosis.
心包积气（PPC）定义为心包腔内存在气体，常导致心脏压塞且死亡率高。本报告描述了一例涉及一名33岁男子的案件，该男子被发现死于离一把刀几米远的地方，其衣服完好，未进行复苏尝试。一条打结的围巾紧紧勒在他脖子上，没有勒痕。尸检CT显示心包腔内有271毫升气体，心脏呈“扁平状”。法医检查发现两处胸部刺伤，一处穿透心包但未穿透心腔，另一处仅为浅表伤。在没有复苏或失血的情况下，且存在一些在窒息情况下观察到的非特异性体征，支持了因压迫性心包积气导致死亡的假说。这例法国首例心包积气病例报告凸显了该实体在法医环境中的罕见性，与文献中描述的其他无相同特征的病例进行比较，指出了其诊断困难以及尸检CT在诊断中的重要性。
