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Postmortem CT and MRI for detecting bowel obstruction in cases of pediatric sepsis deaths

Mária Marosi1, Guillaume Gorincour2, Lucile Tuchtan-Torrents3,4

  • 1Department of Medical Imaging, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.

Medicine, Science, and the Law
|August 28, 2024
PubMed

Insights

Postmortem CT effectively diagnoses pediatric bowel obstruction (BO) in children who died from septic shock. While MRI offered limited added value, CT imaging is crucial for determining the cause of death.

Area of Science:

  • Forensic Pathology
  • Pediatric Radiology
  • Medical Imaging

Background:

  • Septic shock in children can lead to death, with bowel obstruction (BO) as a potential underlying cause.
  • Accurate diagnosis of BO is critical for determining the cause and manner of death in pediatric fatalities.

Purpose of the Study:

  • To evaluate the diagnostic utility of postmortem computed tomography (CT) and magnetic resonance imaging (MRI) for identifying pediatric bowel obstruction (BO) as a cause of death in septic shock cases.
  • To assess the added value of MRI in conjunction with postmortem CT for diagnosing BO.

Main Methods:

  • Retrospective analysis of six pediatric cases with confirmed septic shock and subsequent death.
  • Performance of postmortem CT scans on all cases.
  • Performance of postmortem MRI scans on three of the cases.

Main Results:

  • Postmortem CT scans clearly identified signs of bowel obstruction (BO) in all six pediatric cases.
  • Specific causes of BO identified included volvulus, intussusception, diaphragmatic hernia, and Meckel's diverticulum.
  • Postmortem MRI did not provide additional diagnostic information beyond what was obtained from CT scans.

Conclusions:

  • Postmortem CT is a valuable tool for diagnosing pediatric bowel obstruction (BO) in cases of death due to septic shock.
  • The findings can aid in establishing the cause and manner of death.
  • Further research is warranted to explore the combined utility of CT, MRI, and autopsy for comprehensive diagnosis.

Keywords:
Virtual autopsybowel obstructionforensic radiologypediatric deathpostmortem imagingvirtopsy

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