A fatal case of iatrogenic aortic arch rupture occurred during a tracheostomy. (February 2016)

• Record Type: Journal Article
• Authors: Barranco, Rosario; Leoncini, Andrea; Molinelli, Andrea; Ventura, Francesco
• Is Part Of: Forensic science international. Volume 259(2016)
• Page Start: e5
• Page End: e8
• Publication Date: 2016-02
• Subjects: Aortic arch rupture -- Tracheostomy -- Hemorrhagic hypovolemic shock; Medical jurisprudence -- Periodicals; Chemistry, Forensic -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Chimie légale -- Périodiques; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; Chemistry, Forensic; Medical jurisprudence; Electronic journals; Periodicals; Electronic journals; 614.1
• DOI: 10.1016/j.forsciint.2015.11.016
• Languages: English
• ISSNs: 0379-0738

Abstract

Highlights: Aortic arch rupture in a 60-year-old woman occurred during a tracheostomy. Autopsy showed an aortic arch rupture. The lethal iatrogenic lesion was determined by the aortic arch traction. The death was determined by hemorrhagic hypovolemic shock. Abstract: The authors illustrate a rare case of aortic arch rupture in a 60-year-old woman, occurred during a tracheostomy performed using the Griggs method. The autopsy examination showed an aortic arch rupture in an intermediate position situated in the area between the brachiocephalic artery ostium and the left common carotid artery ostium, associated to a hemorrhage filling of the adjacent connective and muscular tissue. The death was therefore determined by cardiac arrest secondary to massive hemorrhagic hypovolemic shock caused by the aortic arch rupture. The lethal iatrogenic lesion was determined by the aortic arch traction caused by the dilatation. The surgeon's incautious use of the Howard–Kelly forceps introduced in the mediastinum was therefore hypothesized.