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Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
Pneumomediastinum and soft tissue emphysema in pediatric hanging
Tessa Sieswerda-Hoogendoorn1, Anne S Strik, Nick F J Hilgersom
1Department of Forensic Medicine, Netherlands Forensic Institute, PO Box 24044 2490 AA the Hague, The Netherlands; Department of Radiology, Emma Children's Hospital, Academic Medical Centre (AMC), Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Abstract:
Postmortem computed tomography (CT) is increasingly being used as a tool in forensic pathology. The exact value of postmortem imaging in detecting specific conditions has not yet been established, but in specific cases, it can be used as a diagnostic tool demonstrating findings that remain undetected during autopsy, as in this case. Pneumomediastinum and soft tissue emphysema were detected with postmortem CT in a 3-year-old girl after hanging. It was not found during autopsy. This radiological finding matches 3 adult cases previously described. It is assumed that in this case, the first reported in a child, hanging was the most likely cause as well. In the adult cases, it was interpreted as a vital sign; the person must have been alive to create a pressure gradient causing rupture of the alveoli. This case demonstrates one of the added values of postmortem imaging, the possibility of demonstrating findings that remain undetected during autopsy.
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