Article: article from journal or magazin.
Case report (case report): feedback on an observation with a short commentary.
Post-traumatic venous and systemic air embolism associated with spinal epidural emphysema: multi-slice computed tomography diagnosis.
Forensic Science International
Publication types: Case Reports ; Journal ArticlePublication Status: ppublish
A 30-year-old man was admitted with chest trauma after a road traffic accident. The patient was paraplegic and suffered from transient monoparesia of the left arm. The chest X-ray revealed a severe right tension pneumothorax and thoracic spine fractures. Emergency right thoracic drainage was carried out followed by angiography. Unfortunately the patient died and an autopsy was not permitted. Consequently post-mortem multi-slice computed tomography (MSCT) was performed, revealing presence of air inside the right cerebral arteries, bilateral pneumothorax accompanied by a severe right tension pneumothorax, bilateral haematic pleural effusion, pneumomediastinum and bilateral lung contusions. Air was also observed within the right coronary artery, ascending aorta and right ventricle. Thoracic and cervical spinal epidural emphysema were diagnosed. Venous air embolism followed by arterial air embolism producing paradoxical embolism was diagnosed. To the best of our knowledge, this is the first case illustrating by post-mortem MSCT such simultaneous complications after chest trauma as spinal epidural emphysema and cerebral and coronary air embolism.
Accidents, Traffic, Adult, Contusions/radiography, Coronary Angiography, Embolism, Air/radiography, Emphysema/radiography, Epidural Space/radiography, Forensic Medicine, Humans, Intracranial Embolism/radiography, Lung/radiography, Lung Injury, Male, Mediastinal Emphysema/radiography, Pleural Effusion/radiography, Pneumothorax/radiography, Spinal Diseases/radiography, Tomography, X-Ray Computed/methods
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