title: A fatal case of iatrogenic aortic arch rupture occurred during a tracheostomy.
abstract: The authors illustrate a rare case of aortic arch rupture in a 60-year-old woman, occurred during a tracheostomy performed using the Griggs method. The autopsy examination showed an aortic arch rupture in an intermediate position situated in the area between the brachiocephalic artery ostium and the left common carotid artery ostium, associated to a hemorrhage filling of the adjacent connective and muscular tissue. The death was therefore determined by cardiac arrest secondary to massive hemorrhagic hypovolemic shock caused by the aortic arch rupture. The lethal iatrogenic lesion was determined by the aortic arch traction caused by the dilatation. The surgeon's incautious use of the Howard-Kelly forceps introduced in the mediastinum was therefore hypothesized.
authors.affiliation: Department of Legal and Forensic Medicine, University of Genova, Via De Toni 12, 16132 Genova, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Barranco
authors.affiliation: Department of Legal and Forensic Medicine, University of Genova, Via De Toni 12, 16132 Genova, Italy; Legal Medicine Service, ASL 1 Imperia, via Aurelia 97 Bussana, Imperia 18100, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Leoncini
authors.affiliation: Department of Legal and Forensic Medicine, University of Genova, Via De Toni 12, 16132 Genova, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Molinelli
authors.affiliation: Department of Legal and Forensic Medicine, University of Genova, Via De Toni 12, 16132 Genova, Italy. Electronic address: francesco.ventura@unige.it.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ventura
mesh_terms: D001013:Aorta, Thoracic / Q000293:injuries*; D001019:Aortic Rupture / Q000209:etiology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D013525:Surgical Instruments / Q000009:adverse effects*; D014139:Tracheostomy / Q000009:adverse effects* / Q000295:instrumentation*
keywords: Aortic arch rupture; Hemorrhagic hypovolemic shock; Tracheostomy