Gas at postmortem computed tomography--an evaluation of 73 non-putrefied trauma and non-trauma cases.
Postmortem computed tomography (PMCT) has become an important complement in investigating forensic cases allowing an accurate detection of gas accumulations. The present study investigated the presence and distribution of gas in a large number of non-putrefied cases of traumatic and non-traumatic deaths. Furthermore the possibility of pneumobilia secondary to blunt abdominal trauma was studied. Retrospectively, 73 cases, underwent a whole-body PMCT prior to autopsy. These were divided into four groups: penetrating trauma (20 gunshot cases, 13 stabbing cases), blunt abdominal trauma (20 cases) and a control group of 20 non-trauma cases. Exclusion criteria were visible signs of decomposition. Each group was screened for gas accumulations in the vascular system, internal organs, soft tissues and body cavities. Gas accumulations were present in 98% of the trauma cases, compared to 80% of the control group. The most affected structures and/or organs in the trauma group were soft tissues, vessels and the liver. In most cases of the trauma group gas was associated with open injuries and lacerations of vessels. Furthermore, in the gunshot group gas was frequently seen in the intracranial cavity. Pneumobilia occurred in one case of the blunt trauma group; in that control group gas was also seen, but less frequently. Gas accumulation showed a strong association with traumatic events, but even the majority of non-trauma cases showed gas accumulations. Despite the exclusion of cases with visible decomposition signs, a putrefactive origin of gas was assumed in some cases. Gas accumulations are a frequent finding in PMCT with a higher incidence in (open) trauma cases. Even though a differentiation between putrefactive and traumatic gas accumulations is still difficult, knowledge of the circumstance surrounding the case may help identify the origin of gas.
Institute of Forensic Medicine, Center of Forensic Imaging and Virtopsy, University of Bern, Bern, Switzerland. florin.gebhart@students.unibe.ch
Florin T F
FT
Gebhart
B G
BG
Brogdon
Wolf-Dieter
WD
Zech
Michael J
MJ
Thali
Tanja
T
Germerott
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D001808:Blood Vessels / Q000473:pathology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D016022:Case-Control Studies; D004646:Emphysema / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D049429:Forensic Pathology; D005740:Gases; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008643:Mesentery / Q000000981:diagnostic imaging / Q000473:pathology; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology; D010529:Peritoneal Cavity / Q000000981:diagnostic imaging / Q000473:pathology; D011180:Postmortem Changes; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging / Q000473:pathology; D012189:Retrospective Studies; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000473:pathology*; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging / Q000473:pathology*
D005740:Gases