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Massive Systemic Fat Embolism Detected by Postmortem Imaging and Biopsy

NCJ Number
242073
Journal
Journal of Forensic Sciences Volume: 57 Issue: 5 Dated: September 2012 Pages: 1376-1380
Author(s)
Patricia M. Flach, M.D.; Steffen G. Ross, M.D.; Stephan A. Bolliger, M.D.; Garyfalia Ampanozi, M.D.; Gary M. Hutch, M.D.; Corinna Schon, M.D.; Michael J. Thali, M.D.; Tanja Germerott, M.D.
Date Published
September 2012
Length
5 pages
Annotation
Postmortem computed tomography (pmCT) and pmCT angiography (pmCTA) provide a minimally invasive method to determine the cause of death.
Abstract
Postmortem computed tomography (pmCT) and pmCT angiography (pmCTA) provide a minimally invasive method to determine the cause of death. Postmortem image-guided biopsy allows for precise sampling of histological specimens. This case study describes the findings of lethal systemic fat embolism (FE) on whole-body unenhanced pmCT, pmCTA, and image-guided biopsy, with autopsy and histopathologic correlation. Unenhanced pmCT revealed a distinct fat level on top of sedimented layers of corpuscular blood particles and serum in the arterial system and pulmonary trunk. Subsequent pmCTA showed reproducible results, and image-guided biopsy confirmed fatal FE. pm CT/pmCTA combined with image-guided biopsy established the cause of death as right heart failure as a result of systemic fatal FE prior to autopsy. All imaging findings were consistent with traditional autopsy and histological specimens. This unique case demonstrates new imaging findings in massive, fatal FE and highlights that postmortem imaging, supplemented by image-guided biopsy, may detect the cause of death prior to traditional autopsy. Abstract published by arrangement with John Wiley & Sons.