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Thoracic trauma in fatal falls from height - Traumatic pneumopericardium correlates with height of fall and severe injury.
Journal article

Thoracic trauma in fatal falls from height - Traumatic pneumopericardium correlates with height of fall and severe injury.

  • Heimer J Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland. Jakob.Heimer@irm.uzh.ch.
  • Gascho D Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland.
  • Thali MJ Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland.
  • Schweitzer W Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Winterthurerstrasse 190/52, CH-8057, Zurich, Switzerland.
  • 2018-05-05
Published in:
  • Forensic science, medicine, and pathology. - 2018
Falls from heights
Pneumopericardium
Postmortem computed tomography
Tension pneumopericardium
Thoracic trauma
Accidental Falls
Accidents
Adolescent
Adult
Aged
Aged, 80 and over
Aortic Rupture
Child
Female
Forensic Pathology
Fractures, Bone
Heart Injuries
Hemothorax
Humans
Lung Injury
Male
Middle Aged
Pericardium
Pneumopericardium
Pneumothorax
Retrospective Studies
Spinal Fractures
Sternum
Suicide
Tomography, X-Ray Computed
Young Adult
English Pneumopericardium (PPC) describes the collection of gas in the pericardial sac. In tension Pneumopericardium (tPPC), this collection of gas may lead to cardiac tamponade. PPC following blunt trauma is considered a rare finding, as reflected by the low number of case reports on the topic. We analyzed the prevalence and pathophysiology of PPC and the associated trauma in 44 cases of falls from height. We retrospectively analyzed postmortem CT data and autopsy reports of fatal falls in the period March 2014-2017. A valid estimation of the height of the fall and a documented impact on an even and hard surface were inclusion criteria. A total of 44 cases were included in the study. We identified PPC in 18 of the 44 cases, and it was associated with an increased height of the fall, alongside aortic, pericardial, and myocardial ruptures. All cases with PPC also presented with bilateral pneumothorax. Five cases presented with a "ballooning" pericardium, indicating tPPC. PPC is a common finding in cases of falls from great heights. Due to a significant correlation with height and thus impact severity, PPC may be used as a reconstructive element in medico-legal investigations. Association with trauma makes PPC a sign of severe thoracic injury in postmortem and clinical radiology.
Language
  • English
Open access status
closed
Identifiers
Persistent URL
https://sonar.ch/global/documents/191460
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