Pneumomediastinum and soft tissue emphysema of the neck in postmortem CT and MRI; a new vital sign in hanging?

Aghayev, Emin; Yen, Kathrin; Sonnenschein, Martin; Jackowski, Christian; Thali, Michael; Vock, Peter; Dirnhofer, Richard (2005). Pneumomediastinum and soft tissue emphysema of the neck in postmortem CT and MRI; a new vital sign in hanging? Forensic science international, 153(2-3), pp. 181-188. Elsevier Scientific Publ. Ireland 10.1016/j.forsciint.2004.09.124

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Spontaneous pneumomediastinum commonly occurs in healthy young men or parturient women in whom an increased intra-alveolar pressure (Valsalva maneuver, asthma, cough, emesis) leads to the rupture of the marginal pulmonary alveoli. The air ascends along the bronchi to the mediastinum and the subcutaneous space of the neck, causing cervico-fascial subcutaneous emphysema in 70-90% of cases. Ninety-five forensic cases, including five cases of hanging, were examined using postmortem multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) prior to autopsy until December 2003. This paper describes the findings of pneumomediastinum and cervical emphysema in three of five cases of hanging. The mechanism of its formation is discussed based on these results and a review of the literature. In conclusion, when putrefaction gas can be excluded the findings of pneumomediastinum and cervical soft tissue emphysema serve as evidence of vitality of a hanged person. Postmortem cross-sectional imaging is considered a useful visualization tool for emphysema, with a great potential for examination and documentation.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Service Sector > Institute of Legal Medicine
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute for Evaluative Research into Orthopaedic Surgery

UniBE Contributor:

Aghayev, Emin; Yen, Kathrin; Jackowski, Christian; Thali, Michael and Dirnhofer, Richard


600 Technology > 610 Medicine & health




Elsevier Scientific Publ. Ireland




Antoinette Angehrn

Date Deposited:

05 Nov 2015 13:05

Last Modified:

05 Nov 2015 13:05

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