title: Three cases of suprachoroidal hemorrhage associated with chest compression or asphyxiation and detected using postmortem computed tomography.
abstract: We report 3 cases of suprachoroidal hemorrhage (SCH) found to be triggered by increased intrathoracic pressure and detected using postmortem computed tomography (PMCT). Case 1 was a man aged in his 50s who was found dead at a landslide site. The autopsy showed clogging of the upper respiratory tract with soil debris from the landslide. The cause of death was determined to be asphyxia. PMCT showed SCH in both eyes, which was believed to be caused by chest compression or choking on the soil debris from the landslide. Case 2 was a woman aged in her 60s who was found dead in the sea. The autopsy revealed injuries primarily to her chest. We concluded that the cause of death was drowning. PMCT showed SCH in her right eye that was believed to be caused by chest compression. Case 3 was a woman aged in her 80s who was buried in a snowdrift and potentially died from hypothermia. PMCT showed SCH in both eyes, which was considered to be from an increase in intrathoracic pressure that might have been caused by the burial in the snow. Histological findings showed serous retinal detachment associated with retinal pigment epithelium damage due to SCH, which indicated that she was alive for several hours after the onset of SCH. The increase in intrathoracic pressure caused by dyspnea or chest compression was considered responsible for the onset of SCH in all of the present cases. PMCT might assist with the differential diagnosis of traumatic asphyxiation by SCH.
authors.affiliation: Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita 010-8543, Japan. Electronic address: tooshima@med.akita-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Oshima
authors.affiliation: Department of Ophthalmology Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. Electronic address: yossy@med.kyushu-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshikawa
authors.affiliation: Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita 010-8543, Japan. Electronic address: mohtani@doc.med.akita-u.ac.jp.
authors.forename: Maki
authors.initials: M
authors.lastname: Ohtani
authors.affiliation: Department of Forensic Sciences, Akita University Graduate School of Medicine, Akita 010-8543, Japan. Electronic address: mimasaka@med.akita-u.ac.jp.
authors.forename: Sohtaro
authors.initials: S
authors.lastname: Mimasaka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001237:Asphyxia / Q000150:complications* / Q000000981:diagnostic imaging; D001344:Autopsy; D002832:Choroid Hemorrhage / Q000209:etiology*; D003933:Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013909:Thorax; D014057:Tomography, X-Ray Computed
keywords: Asphyxia; Chest compressions; Expulsive hemorrhage; Intrathoracic pressure; Postmortem computed tomography; Suprachoroidal hemorrhage