Ersticken

Brinkmann, B.; Bone, Hans-Georg; Booke, Michael; Chesne, A. Du; Maxeiner, H

doi:10.1007/978-3-662-45345-2_12

Cited by 9 publications

(4 citation statements)

References 190 publications

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“…Interstitial emphysema is described [ 6 , 36 ] as a possible finding, in the older literature as a finding arising with prolonged asphyxia [ 69 ]. In our cases, we could not detect this, which is not in conflict with the literature, as it is not described as a constantly occurring parameter.…”

Section: Discussionmentioning

confidence: 99%

“…A very relevant pulmonary finding is the acute pulmonary emphysema or acute alveolar dilation, respectively [ 3 , 5 ]. In some cases, an interstitial emphysema is described [ 6 , 36 ]. There are only a few differential diagnoses to be considered (e.g., resuscitation or mechanical ventilation [ 37 ], severe asthma [ 38 ]), which in most cases can be easily excluded by the patient’s history.…”

Section: Introductionmentioning

confidence: 99%

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Acute or chronic pulmonary emphysema? Or both?—A contribution to the diagnosis of death due to violent asphyxiation in cases with pre-existing chronic emphysema

et al. 2021

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The diagnosis of death due to violent asphyxiation may be challenging if external injuries are missing, and a typical acute emphysema (AE) “disappears” in pre-existing chronic emphysema (CE). Eighty-four autopsy cases were systematically investigated to identify a (histo-) morphological or immunohistochemical marker combination that enables the diagnosis of violent asphyxiation in cases with a pre-existing CE (“AE in CE”). The cases comprised four diagnostic groups, namely “AE”, “CE”, “acute and chronic emphysema (AE + CE)”, and “no emphysema (NE)”. Samples from all pulmonary lobes were investigated by conventional histological methods as well as with the immunohistochemical markers Aquaporin 5 (AQP-5) and Surfactant protein A1 (SP-A). Particular attention was paid to alveolar septum ends (“dead-ends”) suspected as rupture spots, which were additionally analyzed by transmission electron microscopy. The findings in the four diagnostic groups were compared using multivariate analysis and 1-way ANOVA analysis. All morphological findings were found in all four groups. Based on histological and macroscopic findings, a multivariate analysis was able to predict the correct diagnosis “AE + CE” with a probability of 50%, and the diagnoses “AE” and “CE” with a probability of 86% each. Three types of “dead-ends” could be differentiated. One type (“fringed ends”) was observed significantly more frequently in AE. The immunohistochemical markers AQP-5 and SP-A did not show significant differences among the examined groups. Though a reliable identification of AE in CE could not be achieved using the examined parameters, our findings suggest that considering many different findings from the macroscopical, histomorphological, and molecular level by multivariate analysis is an approach that should be followed.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute or chronic pulmonary emphysema? Or both?—A contribution to the diagnosis of death due to violent asphyxiation in cases with pre-existing chronic emphysema

et al. 2021

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“…Ligature strangulation may cause lethal hypoxemia/ischemia by airway, arterial, and/or venous obstruction. A supralaryngeal positioning of the ligature will produce a complete occlusion of the airway passage (9). However a laryngeal positioning of the ligature, as seen in this case, will most likely compress the larynx posteriorly and only lead to a partially occluded airway.…”

Section: Discussionmentioning

confidence: 99%

“…After losing consciousness, the individual may have a generalized seizure, have decorticate posturing, and/or urinate/defecate. If the compression is released shortly after unconsciousness, the individual gradually may regain consciousness and recover (9). In our case, a partial or an intermittent complete arterial occlusion due to compression and influenced by vessel diameter may have played a contributing factor to this man’s reduced level of consciousness.…”

Section: Discussionmentioning

confidence: 99%

Extensive Petechiae in Attempted Self‐Strangulation

Lambe

Püschel

Anders

2008

Journal of Forensic Sciences

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A 29-year-old Korean man reported to have been robbed, bound, and gagged by a stranger in his apartment. Clinical findings included extensive petechiae to his face and tramline patterned abrasions and ligature furrows to his neck and face as well as his wrists. Initially, no other leads in the investigation existed and a robbery was assumed to have taken place. The man eventually confessed to fabricating the story and to having self-induced the ligature marks by subluxating his jaw at the temporomandibular joint and hooking the rope closest to the back of his neck on the corner of table. The man demonstrated this unsuspected ability to law enforcement officers. As a motive for his unconventional behavior, he confessed to engaging in autoaggressive behavior as punishment for "losing face" after his ex-girlfriend terminated her pregnancy. This case demonstrates that petechiae due to neck compression also may occur in the living and are due to vascular compression and not lethal hypoxia.

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