title: Can post-mortem computed tomography be considered an alternative for autopsy in deaths due to hemopericardium?
abstract: Hemopericardium is a common finding at autopsy, but it may represent a challenge for the forensic pathologist when the etiopathological relationship in causing death is requested. Hemopericardium and cardiac tamponade can be evaluated in living people using radiological techniques, in particular computer tomography (CT). Only a few studies are reported in literature involving post-mortem (PM) cases, where PMCT imaging has been used in order to investigate acute hemopericardium, and they have shown a good accuracy of this technique. Here we report a case involving a 70-year-old white male found dead on the beach, with a medical history of hepatitis C and chronic hypertension with a poor pharmacological response. A PMCT was performed about 3 h after the discovery of the body. The PMCT examination showed an intrapericardial aortic dissection associated to a periaortic hematoma, a sickle-shaped intramural hematoma, a false lumen, and a hemopericardium consisting in fluid and clotted blood. In this case, the PMCT was able to identify the cause of death, even though a traditional autopsy was required to confirm the radiological findings. PMCT is a reliable technique, which in chosen cases, can be performed without the need for a traditional autopsy to be carried out.
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Viale Regina Elena 336, Rome 00185, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Gitto
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Viale Regina Elena 336, Rome 00185, Italy.
authors.forename: Serenella
authors.initials: S
authors.lastname: Serinelli
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Viale Regina Elena 336, Rome 00185, Italy.
authors.forename: Francesco P
authors.initials: FP
authors.lastname: Busardò
authors.affiliation: Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome 00161, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Panebianco
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Viale Regina Elena 336, Rome 00185, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bolino
authors.affiliation: Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Viale Regina Elena 336, Rome 00185, Italy.
authors.forename: Aniello
authors.initials: A
authors.lastname: Maiese
keywords: Aortic dissection; Cardiac tamponade; Computer tomography; Hemopericardium