title: The role of post-mortem CT (PMCT) imaging in the diagnosis of pericardial tamponade due to hemopericardium: A case report.
abstract: Hemopericardium (HP) is frequently found at autopsy, but it represents a challenge for the forensic pathologist when having to assess its etiopathological relationship in causing death, particularly in those cases where ante-mortem clinical and instrumental data are not available. The diagnosis of pericardial tamponade (PT), in fact, is based on signs, symptoms and instrumental evidence and not only on the presence of HP. Post-mortem imaging techniques are actually considered a useful and non-invasive method able to enhance traditional procedures in demonstrating critical forensic findings; consequently, post-mortem imaging methods have been widely introduced in forensic investigations. We report a case of death clearly due to PT caused by ruptured dissected aneurysm of the aorta, submitted to post-mortem CT (PMCT) and PMCT angiography prior to autopsy. PMCT imaging permitted to solve the case without performing autopsy. In the paper we identify PMCT findings suggestive of PT with the aim of verifying the possibility to use post-mortem evidence to retrospectively demonstrate an in vivo dynamic clinical condition, such as PT.
authors.affiliation: Institute of Forensic Medicine, Forensic Imaging and Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland. Electronic address: laura.filograna@rm.unicatt.it.
authors.forename: Laura
authors.initials: L
authors.lastname: Filograna
authors.affiliation: Institute of Forensic Medicine, Forensic Imaging and Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland; Institute of Diagnostic and Interventional Radiology, University Hospital Zurich, Raemistrasse 100, 8091 Zurich, Switzerland.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Flach
authors.affiliation: Institute of Forensic Medicine, Forensic Imaging and Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland.
authors.forename: Stephan A
authors.initials: SA
authors.lastname: Bolliger
authors.affiliation: Institute of Forensic Medicine, Forensic Imaging and Virtopsy, University of Zurich, Winterthurerstrasse 190/52, 8057 Zurich, Switzerland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
mesh_terms: D000784:Aortic Dissection / Q000150:complications; D000792:Angiography; D001014:Aortic Aneurysm / Q000150:complications; D001344:Autopsy; D002305:Cardiac Tamponade / Q000000981:diagnostic imaging* / Q000209:etiology; D049429:Forensic Pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000150:complications*; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Cardiac tamponade; Hemopericardium; Pericardial tamponade; Post-mortem CT; Post-mortem CT angiography