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Научни трудове на Съюза на учените в България-Пловдив Серия Г. Медицина, фармация и дентална медицина т.ХХ1. ISSN 1311-9427 (Print), ISSN 2534-9392 (On-line). 2017. Scientific works of the Union of Scientists in Bulgaria-Plovdiv, series G. Medicine, Pharmacy and Dental medicine, VoLXXI. ISSN 1311-9427 (Print), ISSN 2534-9392 (On-line). 2017.
АСПИРАЦМ НА КРЬВ И СТОМАШНО СПДПРЖИМО В БЕЛИТЕ ДРОБОВЕ ПНА ППТНОР- ТРАНСПНРТНО ПРЖИЗШЕСТВИЕ-
КЛИНИЧЕН РОУЧАЙ Иван Црънчев, Милена Гулинац, Светлозар Спасов, Георги Иванов,
Борислава Теофилова Медицински университет- гр. Пловдив, Катедра по обща и клинична патология и съдебна медицина, УМБАЛ „Св. Георги" ЕАД, гр. Пловдив, Отделение по съдебна медицина, бул. „Васил Априлов"№ 15 А, гр. Пловдив, България
LUNG ASPIRAIION AF OLOOD AND G^^Ai^iriJMC: CONTENTS IN ROAD TRAFFIC ACCIDENT- A CASEP^PORT Ivan Tsranchev, Milena Gulinac, Svetlozar Spasov, Georgi Ivanov,
Borislava Teofilova Medical University Plovdiv, Department of General and Clinical Pathology
and Forensic Medicine, St. George University Multi-Profile Hospital for Active Treatment, Department of Forensic Medicine, 15 Vasil Aprilov Blvd., 4000 Plovdiv, Republic of Bulgaria
Abstract: Death cases caused only by aspiration as a cause of death are really rare, especially in cases of road traffic accidents. Usually they are in the context of other severe traumatic injuries. Here we show a case of a 19-years old, young woman, died in road traffic accident as a passenger on the right front seatplace in a vehicle, hit frontally by another vehicle. All autopsy findings, and the microspopic examination give us the basis that this woman has died from aspiration of blood and gastric contents after the road traffic accident. Keywords: aspiration, road traffic accident, cause of death, gastric contents, blood
Introduction: Every year almost 1.3 million people lose their lives as a result of road traffic accidents, contributing to above 3500 deaths per day world-wide (Saleem et al., 2015). The highest number of injuries found in RTA are head injuries, followed by multiple injuries, thoracic injuries, abdominal injuries, and others injuries (Kalougivaki et al., 2014, Kuchewar et al., 2012). Death cases caused only by aspiration as a cause of death are really rare, especially in cases of road traffic accidents (Ottosson, 1985, Gilroy, 1985). Usually they are in the context of other severe traumatic injuries. Aspiration and large airway obstruction as a cause of death is on average 6 to 11 percent (McNicholl, 1994, Hu et al., 2014) of all death cases.
The case report: Here we show a case of a 19-years old, young woman, died in road traffic accident as a passenger on the right front seatplace in a vehicle, hit frontally by another vehicle.The speed limit on the road in the area of the accident is 90 km. per hour. The woman is found by the emergency physicians dead, on the seatplace.
Damages of the vehicle, in which is found the victim
In the external examination of the corpse we found only superficial bruises and abrasions over the body in the area of head, thorax, and upper and lower limbs. All skeletal bones are presented intact, except nasal bones which are broken. A blunt wound with length 1,5 cm. in the area of the nose is found, which wound's bottom opens into the nasal cavity.In the internal examination of the corpse, the cranial cavity and structures inside are presented intact.
*Obstructed trachea and main bronches with blood and gastric contents, and the aspiration fields of the right lung
**Punctuate haemorrhages of epicardium After examination of thoracic cavity we found the mouth, trachea and main bronches filled with liquid substance including gastric contents and blood (*). On the surface of the lung we saw aspiration fields. The abdominal cavity and organs inside are presented intact. In the stomach we found the same substance as the substance into the airway paths. Except of that, over the lungs
and epicardium of the heart we found punctate hemorrhages(**). The blood into the corpse was dark, and also liquid.
Microscopic features: Histological sections from the periphery of the lungs shows lumens of peripheral branches of the bronchial tree ( small bronchi and pulmonary alveolis ) fill with stomach containts ( food particles , gall ) and blood. Also there is presence of collapsed alveoli ( atelectans) alternating with dilated alveoli and vascular congestion.
H&ExlO ^ " H&E x40
All these autopsy findings, and the microspopic examination give us the basis that this woman has
died from aspiration of blood and gastric contents after the road traffic accident.
Conclusion: Death cases due to aspiration after road traffic accidents are rare but often could lead
to fatal consequences and separately to cause the death of the passengers inside the vehicle,
without any other severe traumatic injuries, which to cause the death.
References:
1. Study of fatal road traffic accidents: based on medico-legal autopsies- Shemaila Saleem, Ayesha Haider, Jehanzeb Khan, Tamkeen Saleem.
2. Retrospective Autopsy Based Study of Fatal Road Traffic Accidents in Fiji- James JVP Kalougivaki and Ramaswamy PS Goundar.
3. Demographic Study and Medico-legal Aspect of Fatal Road Traffic Accident in Aurangabad- S. V. Kuchewar, R. D. Meshram and S. J. Gadge.
4. Aspiration and obstructed airways as the cause of death in 158 consecutive traffic fatalities- Ottosson A.
5. Deaths (144) from road traffic accidents occurring before arrival at hospital- Gilroy D
6. The golden hour and prehospital trauma care- McNicholl BP.
7. Aspiration-Related Deaths in 57 Consecutive Patients: Autopsy Study- Xiaowen Hu, Eunhee S. Yi, and Jay H. Ryu, Luis Seijo.
