Radiographic demonstration of esophageal and tracheal fistulas at autopsy using a contrasting medium that vulcanizes at room temperature.
Esophageal and tracheal fistulas, which occur in 0.05% of medicolegal autopsies, were demonstrated in three cases by a postmortem radiographic technique using silicone rubber/lead oxide as a contrasting medium that vulcanizes at room temperature. In one 83-year-old male, a tracheoesophageal fistula was detected, which had developed after surgical repair of an esophageal rupture caused by a flexible fiberoptic endoscope. In a second case, carcinoma of the esophagus in a 78-year-old male had eroded the trachea and arcus of the aorta creating a fatal tracheoesophagoaortic fistula. In a third case, 55-year-old female developed a tracheobrachicephalic artery fistula as a result of an infiltrating cystic adenocarcinoma of the trachea, resulting in a fatal hemorrhage into the trachea. The results of this study indicate that diagnostic radiologic methods using a vulcanized contrasting medium are useful in supplementing normal dissection in autopsy cases with suspected fistulas of the esophagus or trachea.
Department of Forensic Medicine, University of Helsinki, Finland.
P J
PJ
Karhunen
K
K
Lalu
D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D001344:Autopsy; D016122:Brachiocephalic Trunk; D003287:Contrast Media; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging*; D006801:Humans; D007854:Lead; D008297:Male; D008875:Middle Aged; D010087:Oxides; D011859:Radiography; D012828:Silicones; D013696:Temperature; D014133:Tracheal Diseases / Q000000981:diagnostic imaging*; D014138:Tracheoesophageal Fistula / Q000000981:diagnostic imaging*
D003287:Contrast Media; D010087:Oxides; D012828:Silicones; D007854:Lead; C047365:lead oxide