Pulmonary thromboembolism after air travel: two case reports, the review of literature and forensic implications.
Air travel as a risk factor for pulmonary thromboembolism (PTE) is rarely described in forensic literature. Two cases of PTE after air travel are presented in this report. Each flight was intercontinental and lasted for more than 10 h, resulting in typical "traveler's thrombosis" within 2 weeks. In both cases, the risk factors were age, duration of flight and also peripheral circulation problems caused by heart (hypertension, arrhythmia), and varicose veins failures. Possible pathophysiological mechanisms of thrombus formation in these cases were blood flow stasis from prolonged recumbence, reduced function of the lower leg muscle pump, dehydration, and hypobaric hypoxia. Legal aspects of death due to PTE after air travel and possible responsibility of air companies are discussed.
Institute of Forensic Medicine Milovan Milovanovic, School of Medicine, University of Belgrade, Deligradska 31a, 11000 Belgrade, Serbia. mihailovic@med.bg.ac.rs
Zoran
Z
Mihailovic
Bojana
B
Radnic
Tatjana
T
Atanasijevic
Vesna
V
Popovic
D000367:Age Factors; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000150:complications; D001359:Aviation; D004487:Edema / Q000473:pathology; D049429:Forensic Pathology; D006801:Humans; D006973:Hypertension / Q000150:complications; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011651:Pulmonary Artery / Q000473:pathology; D011655:Pulmonary Embolism / Q000209:etiology* / Q000473:pathology*; D012307:Risk Factors; D013997:Time Factors; D014195:Travel; D014463:Ultrasonography; D014648:Varicose Veins / Q000150:complications; D020246:Venous Thrombosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy
D010975:Platelet Aggregation Inhibitors