Evaluation of usefulness of post-mortem computed tomography in the diagnosis of abdominal parenchymal organ injuries compared to medicolegal autopsy findings

Abstract

Post-mortem computed tomography (PMCT) is an examination technique which provides particular benefits in forensic medical practice in the evaluation of traumatic injuries. However, the usefulness of PMCT in the diagnosis of parenchymal structures in the human body is not obvious. To evaluate the usefulness of PMCT in the diagnosis of parenchymal organ injuries (liver, pancreas, spleen and kidneys) and the presence of blood in the abdominal cavity. The study was conducted on apopulation of deceased persons who underwent medicolegal autopsy in the Chair and Department of Forensic Medicine, Jagiellonian University Medical College in Krakow. The study included cases of violent death with the presence of blunt-force trauma. In all cases studied, the autopsy examination was preceded by PMCT. Both methods were employed to identify signs of injury to parenchymal organs and the presence of blood in the abdominal cavity. Observations made during the autopsies were considered in this study as the gold standard to which the PMCT findings were compared. The data obtained in the study was analyzed statistically to determine arange of parameters including sensitivity, specificity, positive and negative predictive values, and reliability. The values were presented in atabulated form. The evaluation of usefulness of PMCT in the detection of abdominal parenchymal organ injuries and the presence of blood in the abdominal cavity failed to yield satisfactory results that would justify the application of PMCT in medicolegal practice as adiagnostic tool comparable to autopsy. However, promising results were obtained with respect to the suitability of PMCT as ascreening test to exclude the presence of such injuries.