NCJ Number
131259
Journal
Journal of Forensic Sciences Volume: 36 Issue: 4 Dated: (July 1991) Pages: 1129-1133
Date Published
1991
Length
5 pages
Annotation
The application of a radiographic technique using silicone rubber/lead oxide to demonstrate fistulas of the esophagus and trachea is described in three medicolegal autopsy cases from Helsinki, Finland.
Abstract
The method involves the use of a contrasting medium of a silicone rubber/lead oxide solution that vulcanizes at room temperature. Out of the 8337 cases at the Department of Forensic Medicine in the University of Helsinki between 1987 and 1990, 5 cases (0.05 percent) presented with fistulas of the esophagus or trachea. Of these, three were diagnosed by the radiographic technique. One of the cases was associated with iatrogenic endoscopic damage of the esophagus and the other two with malignant intrathoracic tumors. In the former case, the contrasting medium was perfused through a tracheostomy cannula with a portable perfusion device, whereas in the tumor cases, the ascending aorta was first transsected, and the contrasting medium was then perfused in the aorta either manually or with a perfusion device. In all cases, the presence and location of the fistula was clearly imaged. In the case of an 83-year-old male with endoscopically damaged esophagus, the fistula was detected at the end of the trachea just before the bifurcation. In the second case of a 78-year-old male with a carcinoma of the esophagus, the radiograph disclosed a fatal tracheobrachiocephalic artery fistula caused by erosion of the trachea and arcus. In the third case, a 55-year-old female with cystic adenoma of the trachea, the radiograph revealed a tracheobrachiocephalic artery fistula which led to a fatal hemorrhage into the trachea. 2 figures and 13 references (Author abstract modified)