Analysis of cases of traumatic pneumothorax - conclusions based on post-mortem CT examinations for routine autopsy diagnostics

Abstract

The analysis comprised atotal of 450 cases covering the period 2017-2018, in which death was aresult of traffic accident, fall from aheight, and crushing. Post-mortem examinations carried out at the Department of Forensic Medicine in Krakow consisted of conventional autopsy and post-mortem computed tomography (PMCT). The aims of the study were to evaluate the prevalence of pneumothorax in the study group, and attempt to identify acorrelation between pneumothorax and the presence of specific types of thoracic injuries and the circumstances of trauma. Based on the PMCT data, pneumothorax was detected in 43% of cases in the study group. An important finding was the presence of tension pneumothorax with lung collapse and mediastinal shift in 16% of cadavers in the study group. The main injuries accompanying pneumothorax were found to be fractures of the rib cage (ribs, sternum, spine) and lung injuries. In 20% of cases, pneumothorax was shown to coexist with subcutaneous emphysema. In 11% of cases, marked asymmetry of the chest was noted. The circumstances of trauma resulting in the accumulation of air in the pleural cavities included primarily falls from aheight and hits by avehicle.