Fatal secondary aortoduodenal fistula diagnosed with postmortem computed tomography angiography

Gershon, A.S.; Little, D’Arcy; Ball, Christopher; Williams, Andrew S.

doi:10.1007/s12024-020-00256-x

Cited by 4 publications

(1 citation statement)

References 8 publications

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“…As the endoscopic examination is not practical after death and autopsy is not performed in all cases of death, previous case reports indicated the capability of noncontrast-enhanced or contrast-enhanced PMCT to identify the gastrointestinal bleeding site [9,12,13]. The role of an increased CT density in gastrointestinal contents has been emphasized in UGIB diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Cutoff CT value can identify upper gastrointestinal bleeding on postmortem CT: Development and validation study

Okimoto,

Ishida,

Gonoi

et al. 2024

PLoS ONE

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This study aimed to establish the diagnostic criteria for upper gastrointestinal bleeding (UGIB) using postmortem computed tomography (PMCT). This case-control study enrolled 27 consecutive patients with autopsy-proven UGIB and 170 of the 566 patients without UGIB who died in a university hospital in Japan after treatment and underwent both noncontrast PMCT and conventional autopsy between 2009 and 2020. Patients were randomly allocated to two groups: derivation and validation sets. Imaging findings of the upper gastrointestinal contents, including CT values, were recorded and evaluated for their power to diagnose UGIB in the derivation set and validated in the validation set. In the derivation set, the mean CT value of the upper gastrointestinal contents was 48.2 Hounsfield units (HU) and 22.8 HU in cases with and without UGIB. The optimal cutoff CT value for diagnosing UGIB was ≥27.7 HU derived from the receiver operating characteristic curve analysis (sensitivity, 91.7%; specificity, 81.2%; area under the curve, 0.898). In the validation set, the sensitivity and specificity in diagnosing UGIB for the CT cutoff value of ≥27.7 HU were 84.6% and 77.6%, respectively. In addition to the CT value of ≥27.7 HU, PMCT findings of solid-natured gastrointestinal content and intra/peri-content bubbles ≥4 mm, extracted from the derivation set, increased the specificity for UGIB (96.5% and 98.8%, respectively) but decreased the sensitivity (61.5% and 38.5%, respectively) in the validation set. In diagnosing UGIB on noncontrast PMCT, the cutoff CT value of ≥27.7 HU and solid gastrointestinal content were valid and reproducible diagnostic criteria.

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Section: Introductionmentioning

confidence: 99%