The occurrence of sudden death presents
a challenge in legal autopsy
- In cases of sudden death after pneumothorax,
pneumoperitoneum, intravenous infusions, childbirth, operations, or sharp
instrument injuries to the neck and thorax, it is important to check for
air embolism to the heart.
- A postmortem chest x–ray should be taken and inspected
for larger quantities of air in the heart and great vessels.
- Postmortem examination accuracy of observation,
completeness of detail, and sound conclusions can be obtained only when
the postmortem examination is made according to some definite and
systematic plan so that regions and organs are successively examined
without disturbing the relations and appearances yet to be investigated.
- Chest radiographs provide the most reliable method for
determining the extent of pneumothoraces and whether or not a pneumothorax
has resulted in mediastinal shift.
- Detection of a pneumothorax is easily done by holding
the dissected skin and subcutaneous tissues of the chest to form a pocket
adjacent to the ribcage in postmortem examination.
- The pocket is filled with water, and a scalpel is used
to incise the thoracic cavity. The presence of air bubbles indicates a
pneumothorax.
- In the cases of neonates and small infants during the
autopsy, the thorax may be submerged in a bucket of water.
- The apparatuses described previously for detection of
air emboli work equally well for detecting pneumothoraces
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