Postmortem CT investigation of air/gas distribution in the lungs and gastrointestinal tracts of newborn infants: A serial case study with regard to still- and live birth

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• 作者：Tomomi Michiue^a ; ^b ; ^{michi.leg@med.osaka-cu.ac.jp} ; Takaki Ishikawa^a ; ^b ; Osamu Kawamoto^a ; ^b ; Nozomi Sogawa^a ; ^b ; Shigeki Oritani^a ; Hitoshi Maeda^a ; ^b
• 关键词：Forensic radiology ; Postmortem CT ; Gas distribution ; Newborn ; Live birth ; Stillbirth
• 刊名：Forensic Science International
• 出版年：2013
• 出版时间：10 March, 2013
• 年：2013
• 卷：226
• 期：1-3
• 页码：74-80
• 全文大小：1558 K

文摘

Flotation tests on the lungs and gastrointestinal tract to investigate aeration are classic procedures to examine the life of a newborn after birth; however, there are arguments about the reliability. The present study investigated serial forensic autopsy cases of newborn infants without marked decomposition (n = 4) with regard to air/gas distribution in the lungs and gastrointestinal tracts by means of postmortem CT (PM-CT) as well as macromorphology and histology, compared with intrauterine and aborted fetuses (n = 3). No gas was detected in the lungs or gastrointestinal tracts in all of three intrauterine fetal deaths. Gas was diffusely detected in the lungs of a newborn fatality attributed to smothering after birth; however, two neonatal fatalities had poor lung gas contents due to marked congestion with edema and diffuse atelectasis. In a case of unsuccessful cardiopulmonary resuscitation following possible birth asphyxia, pulmonary aeration was evidently localized on CT morphology, despite a larger amount of bowel gas, and was also uneven in histology, showing a membranous immunostaining pattern of pulmonary surfactant on the intra-alveolar surfaces of expanded alveoli. The combined use of PM-CT is useful to demonstrate air/gas distributions in the lungs and gastrointestinal tract for interpretation of spontaneous breathing after birth in newborn fatalities.