Citation

Ro A, Chiba S, Sagi M, Kageyama N, Hayashida M, Ikawa T, Oide Y, Ichiba K, Mukai T. J. Forensic Sci. 2019; 64(5): 1544-1547.

Copyright

(Copyright © 2019, American Society for Testing and Materials, Publisher John Wiley and Sons)

DOI

10.1111/1556-4029.14028

PMID

30786026

Abstract

We present the first report of pneumopericardium observed by autopsy and on postmortem computed tomography (PMCT) images. The subject was a woman who died of self-inflicted stab wounds to the abdomen. The PMCT scan revealed air in the pericardial sac, a "flattened heart" sign, and retroperitoneal hemorrhage. Medicolegal autopsy revealed two abdominal stab wounds near the xiphoid process that had cut the apical pericardium and adjacent diaphragm and liver. Examination of the open thorax confirmed that the pericardial sac was distended with air. The wound extended to the abdominal aorta, causing retroperitoneal hemorrhage. PMCT images showed that the pneumopericardial volume was 133 mL. We believe that cardiac tamponade occurred resulting from the tension pneumopericardium; however, the effects were mitigated by hypovolemia secondary to the retroperitoneal hemorrhage as well as obstructive shock. Therefore, the cause of death appears to have been low-pressure cardiac tamponade.

Language: en

Keywords

Humans; Adult; Female; Suicide; Autopsy; Forensic Medicine; Tomography, X-Ray Computed; forensic pathology; stab wound; forensic science; Hemorrhage; Wounds, Stab; postmortem computed tomography; pneumopericardium; medicolegal autopsy; Abdominal Injuries; Cardiac Tamponade; Pneumopericardium; Aorta, Abdominal; low-pressure cardiac tamponade