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Casado-Suela MA, Cuevas-Tascón G, Cabezas Quintario MA, Duffort-Falco M, Vela de la Cruz L, Burdaspall-Moratilla A, Torres-Macho J, Gimeno Aranguez M, Bernal Jorquera J, Muñoz-Rodriguez J. Could We Consider Ultrasound Guided Minimally Invasive Autopsy as a Part of POCUS? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023. [PMID: 36896883 DOI: 10.1002/jum.16210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
We present a 3-patient case series that support the use of ultrasound guided minimally invasive autopsy (MIA). This technique has a high diagnostic accuracy in specific clinical settings. It makes easier to diagnose pathologies once the patient has died, avoiding body deformation, with a notable reduction in sample processing time compared to the open autopsy study and, therefore, a shorter overall diagnostic response time. MIA shows some similarities with point of care ultrasound (POCUS), like examination protocols or that they can be performed at the bedside.
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Affiliation(s)
- Miguel Angel Casado-Suela
- Internal Medicine Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
- Department of Medicine, Complutense University, Madrid, Spain
| | - Guillermo Cuevas-Tascón
- Internal Medicine Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
- Department of Medicine, Complutense University, Madrid, Spain
| | - María Antonia Cabezas Quintario
- Department of Medicine, Complutense University, Madrid, Spain
- Pathology Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
| | - Mercedes Duffort-Falco
- Internal Medicine Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
- Department of Medicine, Complutense University, Madrid, Spain
| | - Laura Vela de la Cruz
- Internal Medicine Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
- Department of Medicine, Complutense University, Madrid, Spain
| | - Ana Burdaspall-Moratilla
- Department of Medicine, Complutense University, Madrid, Spain
- Pathology Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
| | - Juan Torres-Macho
- Internal Medicine Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
- Department of Medicine, Complutense University, Madrid, Spain
| | - Margarita Gimeno Aranguez
- Department of Medicine, Complutense University, Madrid, Spain
- Pathology Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
| | - Javier Bernal Jorquera
- Department of Medicine, Complutense University, Madrid, Spain
- Pathology Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
| | - Jorge Muñoz-Rodriguez
- Department of Medicine, Complutense University, Madrid, Spain
- Pathology Department, Infanta Leonor-Virgen de la Torre University Hospital, Madrid, Spain
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Ducloyer M, Carballeira-Alvarez A, Tuchtan L, Delteil C, Piercecchi-Marti MD, Gorincour G, Prodhomme O. Normal Post-mortem Imaging Findings in Foetuses and Children. FORENSIC IMAGING 2022. [DOI: 10.1007/978-3-030-83352-7_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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A 5-Year Retrospective Study on Infant Homicide Presenting as Cot Death: Are we missing infant homicides? Am J Forensic Med Pathol 2021; 42:324-327. [PMID: 34054016 DOI: 10.1097/paf.0000000000000693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Being found dead in cot or bed is the most common presentation encountered with infant deaths. These deaths are often associated with unsafe sleep environment. The postmortem examination in such cases is often negative, and along with family objections, cultural, and other factors, may lead to a coroner considering not authorizing a postmortem examination. However, not identifying a homicide is a potential risk if a postmortem examination is not performed. This 5-year retrospective study investigated the proportion of infant homicide death initially presenting as cot death. Of a total of 103 cases of infants initially presenting as being found dead in cot or bed, 3 (approximately 3%) were classified as homicides after postmortem examination. During the study period, a total of 9 infant homicides were reported, translating to 33% (3 of 9) of infant homicides presented as cot deaths. Postmortem radiology was a valuable adjunct, but was unable to recognize 2 of the homicide cases with traumatic head injuries (with subdural hemorrhage and brain injury only). We strongly advocate that all infant deaths presenting as cot death require a full postmortem examination.
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Gascho D, Bolliger SA, Thali MJ. CT and MRI of a transcardiac gunshot wound with an annular distribution of bullet fragments surrounding an exit-re-entrance wound after the bullet burst from a floor tile upon exiting the lying body. J Forensic Leg Med 2020; 77:102087. [PMID: 33249345 DOI: 10.1016/j.jflm.2020.102087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/04/2020] [Accepted: 11/14/2020] [Indexed: 01/19/2023]
Abstract
This case report describes medicolegal examinations of a decedent with a fatal gunshot wound. The decedent lied on the floor as a bullet was fired into his chest. Computed tomography (CT) and magnetic resonance imaging (MRI) were performed as part of the judicial investigation. The MRI examination was valuable for delineating the wound channel through the left ventricle, which was deemed the main cause for internal bleeding and fatal blood loss. The diagnostic value of CT for the detection of injuries was low in this case. However, CT allowed for the virtual investigation of bullet fragments. According to CT-based dual-energy index calculations, it could be inferred that the fragments were most likely made of lead matching .357 Magnum R-P cartridges that were found at the scene. The bullet fragments were located underneath the skin at the suspected exit wound. The exit wound was actually an exit-re-entrance wound, as it can be assumed that the fragments re-entered the body after the bullet burst from hard ground upon exiting the body of the decedent, who was lying on the floor. CT visualized an uncommon annular distribution pattern for the bullet fragments surrounding the exit-re-entrance wound. The formation of such an annular distribution pattern of bullet fragments and the relevant conclusions that may be drawn from such a distribution pattern are discussed in this article.
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Affiliation(s)
- Dominic Gascho
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland.
| | - Stephan A Bolliger
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Michael J Thali
- Department of Forensic Medicine and Imaging, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
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Tse R, Morrow P, Sage M, Stables S. Targeted and minimally invasive post-mortem examination with total body computed tomography not recommended in New Zealand. Forensic Sci Med Pathol 2020; 17:373-374. [PMID: 32897531 DOI: 10.1007/s12024-020-00303-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Rexson Tse
- Northern Forensic Pathology Service of New Zealand, LabPLUS, Auckland City Hospital, Auckland, 1023, New Zealand.
| | - Paul Morrow
- Northern Forensic Pathology Service of New Zealand, LabPLUS, Auckland City Hospital, Auckland, 1023, New Zealand
| | - Martin Sage
- Canterbury District Health Board, Christchurch, 8011, South Island, New Zealand
| | - Simon Stables
- Northern Forensic Pathology Service of New Zealand, LabPLUS, Auckland City Hospital, Auckland, 1023, New Zealand
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