Судебная Медицина (Mar 2020)
VIRTOPSY FOR STUDYING THE SUDDEN DEATH OF AN ADOLESCENT
Abstract
The article discusses the application of pre-autopsy computed tomography (Virtopsy) for studying the sudden death of an adolescent with undiagnosed Marfan syndrome. Aim. To identify the capabilities of the pre-autopsy computed tomography (CT) in determining the cause of the sudden death of an adolescent, as well as the extent of injuries, if present. Material and methods. A CT scan was obtained at the Department of Diagnostic Radiology of a district hospital using a modern multifunctional CT scanner Siemens SOMATOM Perspective (64-slice configuration, slice width of 1.5 mm). Results. The forensic medical examination revealed the following information about the corpse: asthenic body type, a height of 178 cm, long extremities, thin and long spider-like fingers, pectus excavatum, little fat beneath the skin and poor muscle development; blood in the pericardium, rupture of the dissecting aneurysm of the ascending aorta. The histological examination of the aorta revealed its dramatic thinning, fragmentation of the elastic fibres along with the alteration of the elastic framework, fragmentation and poor development of muscle fibres in the media. A CT scan showed the rupture of the dissecting aneurysm of the ascending thoracic aorta with para-aortic haematoma and cardiac tamponade. Conclusion. The analysis of obtained data allowed us to diagnose a multisystemic disorder of connective tissue (Marfan syndrome) undiagnosed intra vitam. The sudden death was caused by the rupture of the dissecting aneurysm of the ascending aorta which is a complication of the congenital genetic pathology. Intravitam CT or MRI scans of children being at risk of the multisystemic disorder of connective tissue will help detect pathological changes in the aortic wall and perform cardiac surgery promptly which would significantly increase the length of life and improve its quality for such patients.
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