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Abdominal Stab Wounds with Tension Pneumopericardium Confirmed by Autopsy and Postmortem Computed Tomography
Author(s) -
Ro Ayako,
Chiba Shoetsu,
Sagi Morihisa,
Kageyama Norimasa,
Hayashida Makiko,
Ikawa Toru,
Oide Yukino,
Ichiba Kazue,
Mukai Toshiji
Publication year - 2019
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.14028
Subject(s) - medicine , pneumopericardium , autopsy , cardiac tamponade , pericardium , tamponade , abdomen , stab wound , surgery , great vessels , radiology , abdominal aorta , hemothorax , stab , retroperitoneal hemorrhage , aorta , pneumothorax , pathology
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.