[Causality of an accident in subsequent fatal pulmonary embolism a few hours after trauma].
An 87-year-old woman, who was largely immobilized in a wheelchair, suffered rib fractures and an unstable fracture of the pelvic ring in a fall. Approximately 2 1/2 hours later she developed marked clinical symptoms of pulmonary thromboembolism and died 5 hours after the accident. The question to be discussed with regard to the causality was the unusually short interval of only 2 1/2 to 5 hours between the accident and the clinical signs of embolism leading to her death. Current literature gives only rough outlines stating that thromboembolism can occur as early as the first day after the trauma. An alternative theory explaining the pulmonary thromboembolism may be the breaking off of a pre-existing thrombus due to manipulation during transport or diagnostic measures in connection with the unstable fracture of the pelvic ring.
Institut für Rechtsmedizin und Verkehrsmedizin, Universität Heidelberg.
Andrea
A
Dettling
Ingo
I
Pedal
Hans-Thomas
HT
Haffner
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D001924:Brain Concussion / Q000473:pathology*; D002423:Cause of Death; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D017809:Fatal Outcome; D005260:Female; D050723:Fractures, Bone / Q000473:pathology*; D006333:Heart Failure / Q000473:pathology; D006707:Homes for the Aged / Q000331:legislation & jurisprudence; D006801:Humans; D016365:Liability, Legal; D009735:Nursing Homes / Q000331:legislation & jurisprudence; D011651:Pulmonary Artery / Q000473:pathology; D011655:Pulmonary Embolism / Q000473:pathology*