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Pneumomediastinum and Soft Tissue Emphysema in Pediatric Hanging
Authors:Tessa Sieswerda‐Hoogendoorn MD  MSc  Anne S Strik  Nick F J Hilgersom  Vidija Soerdjbalie‐Maikoe MD  PhD  Rick R van Rijn MD  PhD
Institution:1. Department of Forensic Medicine, Netherlands Forensic Institute, , The Netherlands;2. Department of Radiology, Emma Children's Hospital, Academic Medical Centre (AMC), , 1105 AZ Amsterdam, The Netherlands;3. Faculty of Medicine, Academic Medical Centre (AMC), University of Amsterdam, , 1105 AZ Amsterdam, The Netherlands
Abstract:Postmortem computed tomography (CT) is increasingly being used as a tool in forensic pathology. The exact value of postmortem imaging in detecting specific conditions has not yet been established, but in specific cases, it can be used as a diagnostic tool demonstrating findings that remain undetected during autopsy, as in this case. Pneumomediastinum and soft tissue emphysema were detected with postmortem CT in a 3‐year‐old girl after hanging. It was not found during autopsy. This radiological finding matches 3 adult cases previously described. It is assumed that in this case, the first reported in a child, hanging was the most likely cause as well. In the adult cases, it was interpreted as a vital sign; the person must have been alive to create a pressure gradient causing rupture of the alveoli. This case demonstrates one of the added values of postmortem imaging, the possibility of demonstrating findings that remain undetected during autopsy.
Keywords:forensic science  postmortem radiology  autopsy  hanging  pneumomediastinum  emphysema
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