Application of PMCT in cases of deaths potentially caused by tension pneumothorax

Introduction The standard autopsy technique allows checking for the presence of air in pleural cavities, but it is very problematic to estimate the volume of gas. So it is hard to evaluate significance of the symptom, especially for considering as the cause of death. Methods Retrospectively, among routinely examined 269 cases with application of PMCT preceding conventional autopsy in 6-month' time (from August 2012)—cases with apparent PMCT signs of tension pneumothorax (a large sided pneumothorax with mediastinal shift to the side and flattening of the hemidiaphragm) were chosen and analyzed in relation to the actual cause of death. Results 73 (about 27% of the total) cases with presence of air in pleural cavity/ies were reported, out of them 11 with features of tension pneumothorax, in 5 very apparent. Cases of tension pneumothorax were not only limited to post-traumatic changes (it seems that most interesting was the case of a single stab wound with the damage of the left lung through the diaphragm, in which PMCTA disclosed lack of significant leakage from bigger blood vessels), one case was related to pneumonia. Conclusion PMCT in contrast to conventional autopsy gives evidence of pneumothorax easily and “repeatedly”, providing opportunities for identification of tension pneumothorax as the cause of death.