Keil W, Kondo T, Beer G M
Institute of Legal Medicine, Ludwig-Maximilians-University, Munich, Germany.
Forensic Sci Int. 1998 Aug 12;95(3):225-30. doi: 10.1016/s0379-0738(98)00100-5.
Atraumatic haemorrhages in the posterior cricoarytenoid (PCA) muscles can be observed for from 1% to 9% of various causes of death. It has been claimed that there is an association between these findings and the cause of death, particularly coronary death. Additionally it has been assumed that haemorrhages in the PCA muscles may be caused by an asphyxial mechanism and it has even been suggested that the haemorrhages may be a "sign" which could be used to differentiate between natural and unnatural death. Because of the differing views we carried out additional research into the course of these haemorrhages. Six characteristic cases out of 2060 autopsies with macroscopically diagnosed haemorrhages in the PCA muscles are presented. The six cases included acute heart failure, death caused by bolus, drowning, trauma of brain and skull, exsanguination from polytrauma and choking after aspiration of vomit. These cases were completely different with regard to all the circumstances of death. On the basis of these findings and in contrast to the literature it cannot be shown that proofs exist for a correlation between the haemorrhages and the causes and the manner of death. As a consequence it must be stated that haemorrhages in the PCA muscles do not have any diagnostic significance.
环状杓后肌（PCA）的无创伤性出血在各种死因中占比为1%至9%。据称，这些发现与死因之间存在关联，尤其是冠状动脉死亡。此外，有人认为PCA肌内出血可能由窒息机制引起，甚至有人提出这些出血可能是一种“体征”，可用于区分自然死亡和非自然死亡。由于观点各异，我们对这些出血的过程进行了进一步研究。本文展示了2060例尸检中6例具有代表性的病例，这些病例在尸检中宏观诊断出PCA肌内有出血。这6个病例包括急性心力衰竭、大剂量用药致死、溺水、脑和颅骨创伤、多发伤失血以及呕吐物误吸后窒息。这些病例在所有死亡情况方面完全不同。基于这些发现，与文献观点相反，无法证明PCA肌内出血与死因及死亡方式之间存在相关性。因此，必须指出，PCA肌内出血没有任何诊断意义。
