Document Detail

Pneumomediastinum and soft tissue emphysema of the neck in postmortem CT and MRI; a new vital sign in hanging?
MedLine Citation:
PMID:  16139108     Owner:  NLM     Status:  MEDLINE    
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.
Emin Aghayev; Kathrin Yen; Martin Sonnenschein; Christian Jackowski; Michael Thali; Peter Vock; Richard Dirnhofer
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2004-11-11
Journal Detail:
Title:  Forensic science international     Volume:  153     ISSN:  0379-0738     ISO Abbreviation:  Forensic Sci. Int.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-05     Completed Date:  2005-12-13     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7902034     Medline TA:  Forensic Sci Int     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  181-8     Citation Subset:  IM    
Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, 3012 Bern, Switzerland.
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MeSH Terms
Forensic Medicine*
Liver / pathology
Magnetic Resonance Imaging
Mediastinal Emphysema / pathology*
Neck / pathology
Neck Injuries / pathology*
Spleen / pathology
Subcutaneous Emphysema / pathology*
Tomography, X-Ray Computed

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