Window test for pneumothorax

Pneumothorax can be defined as the presence of gas within the pleural space between the lung and the chest wall. When a pneumothorax is suspected, particularly when we have evidence or suspect thoracic trauma, forensic pathologists always perform tests for pneumothorax. However, in our opinion, it can and should be performed not only in traumatic forensic autopsy because pneumothorax can also occur in non-traumatic circumstances, and determining at autopsy whether the deceased has a pneumothorax is extremely important in identifying the cause, mechanism, and manner of death. The basis for diagnosing a pneumothorax, as most textbooks describe, is the water test and X-ray, or postmortem computed tomography. However, for organizational reasons, these methods are difficult to apply routinely, thereby increasing the risk of overlooking this condition. We would, therefore, like to recall the window test for pneumothorax, which is rarely described in textbooks. It is a simple, fast, and effective solution that can be implemented routinely during any autopsy, requiring little time and no specialized equipment or assistance. In this paper, we demonstrate how to perform and interpret this test. We also included a supporting instructional video.