NCJ Number
140077
Journal
Journal of Forensic Sciences Volume: 37 Issue: 5 Dated: (September 1992) Pages: 1346-1351
Date Published
1992
Length
6 pages
Annotation
The use of postmortem angiography fulfills three roles: diagnosis of catheter-induced pulmonary artery perforation; localization of the perforation to guide the search for a tissue diagnosis; and determination of the true incidence of perforation among patients recently monitored invasively.
Abstract
The reported case of pulmonary artery perforation by the placement of a balloon-tipped, flow-directed catheter involved a 71-year-old man. On autopsy, his lungs were obtained en bloc with mainstem bronchi and trachea. Gross examination revealed diffuse right lung hemorrhage. Dissection of the pulmonary vasculature, guided by an angiogram, revealed a 1.2-centimeter longitudinal laceration, 3 centimeters beyond the bifurcation of the right pulmonary artery. Histological examination of a section of the involved artery indicated a disruption in the arterial wall with underlying fibrinoid debris, fragments of collagen and elastin, hemorrhage, and inflammation. Cut sections of the right lung revealed diffuse hemorrhage, with no localized hematoma, thrombus, or cavity. Angiography proved to be effective in the postmortem diagnosis and localization of pulmonary artery perforation. By facilitating the detection of arterial perforation, postmortem angiography may assist in documenting the manner and cause of death when procedural mishap is a concern. 10 references and 2 figures