Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings.

Zech, Wolf-Dieter; Jackowski, Christian; Schwendener, Nicole; Brencicová, Eva; Schuster, Frederick; Lombardo, Paolo (2016). Postmortem CT versus forensic autopsy: frequent discrepancies of tracheobronchial content findings. International journal of legal medicine, 130(1), pp. 191-198. Springer 10.1007/s00414-015-1264-5

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In their daily forensic casework, the authors experienced discrepancies of tracheobronchial content findings between postmortem computed tomography (PMCT) and autopsy to an extent previously unnoticed in the literature. The goal of this study was to evaluate such discrepancies in routine forensic cases. A total of 327 cases that underwent PMCT prior to routine forensic autopsy were retrospectively evaluated for tracheal and bronchial contents according to PMCT and autopsy findings. Hounsfield unit (HU) values of tracheobronchial contents, causes of death, and presence of pulmonary edema were assessed in mismatching and matching cases. Comparing contents in PMCT and autopsy in each of the separately evaluated compartments of the respiratory tract low positive predictive values were assessed (trachea, 38.2 %; main bronchi, 40 %; peripheral bronchi, 69.1 %) indicating high discrepancy rates. The majority of tracheobronchial contents were viscous stomach contents in matching cases and low radiodensity materials (i.e., HU < 30) in mismatching cases. The majority of causes of death were cardiac related in the matching cases and skull/brain trauma in the mismatching cases. In mismatching cases, frequency of pulmonary edema was significantly higher than in matching cases. It can be concluded that discrepancies in tracheobronchial contents observed between PMCT and routine forensic autopsy occur in a considerable number of cases. Discrepancies may be explained by the runoff of contents via nose and mouth during external examination and the flow back of tracheal and main bronchial contents into the lungs caused by upright movement of the respiratory tract at autopsy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Service Sector > Institute of Legal Medicine > Forensic Medicine
04 Faculty of Medicine > Service Sector > Institute of Legal Medicine

UniBE Contributor:

Zech, Wolf-Dieter; Jackowski, Christian; Schwendener, Nicole; Brencicová, Eva; Schuster, Frederick and Lombardo, Paolo

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0937-9827

Publisher:

Springer

Language:

English

Submitter:

Antoinette Angehrn

Date Deposited:

05 Nov 2015 13:27

Last Modified:

15 Jan 2016 01:30

Publisher DOI:

10.1007/s00414-015-1264-5

PubMed ID:

26400026

Uncontrolled Keywords:

Aspiration; Discrepancy; Forensic radiology; PMCT; Tracheobronchial content

BORIS DOI:

10.7892/boris.72816

URI:

https://boris.unibe.ch/id/eprint/72816

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