title: Non-traumatic and spontaneous hemothorax in the setting of forensic medical examination: a systematic literature survey.
abstract: Spontaneous hemothorax is a well-known yet seldom-reported entity in forensic literature. While trauma-related hemothorax is frequently encountered in a medicolegal setting, non-traumatic and spontaneous hemothorax are relatively uncommon entities. The wide range of causes that can trigger fatal intrathoracic bleeding include thoracic aortic dissection, followed by vascular malformations, various oncological diseases, and connective tissue abnormalities. In rare instances, extramedullary hematopoiesis, ectopic pregnancy, congenital heart defects, amyloidosis, or parasitic diseases may constitute a source of bleeding. This etiological heterogeneity may, as a result, cause diagnostic difficulties during post-mortem elucidation of hemothorax. It should be borne in mind that hemothorax after low-energy trauma does not exclusively indicate traumatic hemorrhage, hence, the non-traumatic origin of bleeding must be taken into consideration. In this paper, we present a systematic review of the relevant literature enriched by the results of our observations to investigate the etiologies and recommendations for the post-mortem diagnosis of spontaneous hemothorax in an attempt to better delineate the possible medicolegal considerations. It is important that forensic pathologist as well as clinicians are aware of the diseases that could potentially give rise to fatal hemothorax.
authors: Institute of Forensic Medicine and Medicolegal Expertises, Jessenius Faculty of Medicine, Comenius University, University Hospital, Martin, Slovak Republic. Electronic address: janik.mato@gmail.com.
authors: Martin
authors: M
authors: Janik
authors: Institute of Forensic Medicine and Medicolegal Expertises, Jessenius Faculty of Medicine, Comenius University, University Hospital, Martin, Slovak Republic.
authors: Lubomir
authors: L
authors: Straka
authors: Institute of Forensic Medicine and Medicolegal Expertises, Jessenius Faculty of Medicine, Comenius University, University Hospital, Martin, Slovak Republic.
authors: Jozef
authors: J
authors: Krajcovic
authors: Institute of Forensic Medicine, Faculty of Medicine, Charles University and University Hospital, Hradec Kralove, Czech Republic.
authors: Petr
authors: P
authors: Hejna
authors: Department of thoracic surgery, Jessenius Faculty of Medicine, Comenius University, University Hospital, Martin, Slovak Republic.
authors: Julian
authors: J
authors: Hamzik
authors: Institute of Forensic Medicine and Medicolegal Expertises, Jessenius Faculty of Medicine, Comenius University, University Hospital, Martin, Slovak Republic.
authors: Frantisek
authors: F
authors: Novomesky
mesh_terms: D000686:Amyloidosis / Q000150:complications; D000784:Aortic Dissection / Q000150:complications; D017542:Aneurysm, Ruptured / Q000150:complications; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects; D004445:Echinococcosis, Pulmonary / Q000150:complications; D004535:Ehlers-Danlos Syndrome / Q000150:complications; D004715:Endometriosis / Q000150:complications; D005096:Exostoses / Q000150:complications; D005260:Female; D049429:Forensic Pathology; D006330:Heart Defects, Congenital / Q000150:complications; D006402:Hematologic Diseases / Q000150:complications; D006491:Hemothorax / Q000209:etiology* / Q000473:pathology; D006801:Humans; D009369:Neoplasms / Q000150:complications; D011030:Pneumothorax / Q000150:complications; D012272:Ribs; D013896:Thoracic Diseases / Q000150:complications; D054079:Vascular Malformations / Q000150:complications
keywords: Diagnostics; Etiology; Post-mortem evaluation; Spontaneous hemothorax; Sudden death