Sudden unexpected death in a 16-month-old child

The Use of Pulmonary Interstitial Emphysema as an Indicator of Live Birth

“…Cases of spontaneous PIE in infants and older children have also been reported, usually related to congenital cystic lesions or severe pulmonary infection with damage to the alveolar architecture, allowing air to dissect into the interstitial space (11)(12)(13). Pulmonary interstitial emphysema has also been seen after vigorous resuscitation efforts by individuals not accustomed to the small lung volumes of infants, or as a result of unaided forceful respiratory efforts against a fixed object that does not permit air to enter, such as inspissated mucus in the airways (14 -15) or an inhaled foreign object (16). To our knowledge, however, PIE has not been previously reported as an indicator of live birth in cases where the birth and death were unattended.…”