Surgical interventions with fatal outcome: Utility of multi-phase postmortem CT angiography

Détails

ID Serval
serval:BIB_F18EE12141F6
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Surgical interventions with fatal outcome: Utility of multi-phase postmortem CT angiography
Périodique
Forensic Sci Int
Auteur(s)
Zerlauth J. B., Doenz F., Dominguez A., Palmiere C., Uske A., Meuli R., Grabherr S.
ISSN
0379-0738
ISSN-L
1872-6283 (Electronic)
Statut éditorial
Publié
Date de publication
02/2013
Volume
225
Numéro
1-3
Pages
32-41
Notes
Zerlauth, J-BDoenz, FDominguez, APalmiere, CUske, AMeuli, RGrabherr, SIrelandForensic Sci Int. 2013 Feb 10;225(1-3):32-41. doi: 10.1016/j.forsciint.2012.05.013. Epub 2012 Jun 19.
Résumé
Cases of fatal outcome after surgical intervention are autopsied to determine the cause of death and to investigate whether medical error caused or contributed to the death. For medico-legal purposes, it is imperative that autopsy findings are documented clearly. Modern imaging techniques such as multi-detector computed tomography (MDCT) and postmortem CT angiography, which is used for vascular system imaging, are useful tools for determining cause of death. The aim of this study was to determine the utility of postmortem CT angiography for the medico-legal death investigation. This study investigated 10 medico-legal cases with a fatal outcome after surgical intervention using multi-phase postmortem whole body CT angiography. A native CT scan was performed as well as three angiographic phases (arterial, venous, and dynamic) using a Virtangio((R)) perfusion device and the oily contrast agent, Angiofil((R)). The results of conventional autopsy were compared to those from the radiological investigations. We also investigated whether the radiological findings affected the final interpretation of cause-of-death. Causes of death were hemorrhagic shock, intracerebral hemorrhage, septic shock, and a combination of hemorrhage and blood aspiration. The diagnoses were made by conventional autopsy as well as by postmortem CT angiography. Hemorrhage played an important role in eight of ten cases. The radiological exam revealed the exact source of bleeding in seven of the eight cases, whereas conventional autopsy localized the source of bleeding only generally in five of the seven cases. In one case, neither conventional autopsy nor CT angiography identified the source of hemorrhage. We conclude that postmortem CT angiography is extremely useful for investigating deaths following surgical interventions. This technique helps document autopsy findings and allows a second examination if it is needed; specifically, it detects and visualizes the sources of hemorrhages in detail, which is often of particular interest in such cases.
Mots-clé
Postmortem, Computed tomography, Angiography, Medical error, Forensic radiology, Fatal outcome, Malpractice
Pubmed
Web of science
Création de la notice
19/02/2013 11:00
Dernière modification de la notice
29/05/2018 10:17
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