Asphyxial death related to postextraction hematoma in an elderly man

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• 作者：Wataru Kawashima ; ^{watack14@naramed-u.ac.jp} ; Katsuhiko Hatake ; Yoshifumi Morimura ; Risa Kudo ; Mari Nakanishi ; Shigehiro Tamaki ; Shogo Kasuda ; Katsuya Yuui ; Akiko Ishitani
• 关键词：Asphyxia ; Autopsy ; Hematoma ; Postextraction bleeding ; Tooth extraction
• 刊名：Forensic Science International
• 出版年：2013
• 出版时间：10 May, 2013
• 年：2013
• 卷：228
• 期：1-3
• 页码：e47-e49
• 全文大小：767 K

文摘

We here report an autopsy case of a man in his seventies who died from asphyxia due to compression of the trachea caused by postextraction bleeding after extraction of his left mandibular third molar by a dentist in private practice. On the morning after the tooth extraction, he had complained of dyspnea and became unconscious at home. Although he was brought to the emergency room by ambulance, he died 7 days later without regaining consciousness. Autopsy examination revealed that the lingual side of the alveolar bone was fractured at the extraction socket. Moreover, subcutaneous bleeding that extended from the extraction socket to the thyrohyoid ligament in the cervical region and deviation of the epiglottis due to the bleeding were observed. Histological findings revealed liver cirrhosis; there were no significant findings in other organs. On the basis of these findings, we concluded that alveolar bone fracture occurred during the extraction and that the bleeding spread to the cervical region. Thus, the patient had died from asphyxia resulting from airway obstruction caused by cervical subcutaneous bleeding derived from postextraction bleeding. We emphasize that tooth extraction may cause fatal complications in patients with bleeding tendencies, particularly in the elderly.