Abdominal Stab Wounds with Tension Pneumopericardium Confirmed by Autopsy and Postmortem Computed Tomography

• Ro, Ayako ^[1] ; Chiba, Shoetsu ^[1] ; Sagi, Morihisa ^[1] ; Kageyama, Norimasa ^[1] ; Hayashida, Makiko ^[1] ; Ikawa, Toru ^[1] ; Oide, Yukino ^[1] ; Ichiba, Kazue ^[1] ; Mukai, Toshiji ^[1]
  1. [1] St. Marianna University School of Medicine

     St. Marianna University School of Medicine

     Kawasaki Ku, Japón

     
• Localización: Journal of forensic sciences, ISSN-e 1556-4029, ISSN 0022-1198, Vol. 64, Nº. 5, 2019, págs. 1544-1547
• Idioma: inglés
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• Resumen

  • 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 thathad cut the apical pericardium and adjacent diaphragm and liver. Examination of the open thorax confirmed that the pericardial sac was dis-tended with air. The wound extended to the abdominal aorta, causing retroperitoneal hemorrhage. PMCT images showed that the pneumoperi-cardial volume was 133 mL. We believe that cardiac tamponade occurred resulting from the tension pneumopericardium; however, the effectswere mitigated by hypovolemia secondary to the retroperitoneal hemorrhage as well as obstructive shock. Therefore, the cause of death appearsto have been low-pressure cardiac tamponade