European Journal of Biomedical and Pharmaceutical Sciences

POSTMORTEM COMPUTED TOMOGRAPHY SHOWED MASSIVE GASES IN THE BRAIN, HEART, LIVER, AND KIDNEY: A CASE REPORT

*Tomoki Nishiyama MD, PhD

ABSTRACT

We experienced a case whose postmortem computed tomography (PMCT) showed massive gases detected in the brain, heart, liver, and kidney. An 85-year-old man, who had emphysema and dementia, was taken in the ambulance under cardiopulmonary resuscitation(CPR), manual ventilation with mask, chest compression, intravenous adrenaline administration by paramedics. When he arrived at our hospital, jaw rigidity was found, and electrocardiogram showed asystole. Therefore, we abandoned CPR which continued about 40 minutes. About 2 hours might have passed since cardiac arrest. PMCT was performed immediately. Massive gases were observed in the brain, heart, liver, and kidney. No clear cause of death was observed in PMCT other than obstructed bilateral bronchi, which might induce asphyxia, and/or increase intra-alveolar pressure to induce barotrauma and gas embolism. Mask ventilation and/or chest compression might also break the alveoli in emphysema to induce gas embolism. We should keep in mind that PMCT might show massive gases in many organs even with a short duration of CPR, though whether these were cause of death or results of CPR was not clear.

Keywords: PMCT, CPR.