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We had the opportunity to give our expert opinion on two cases, in which the physician did not make the appropriate diagnosis of cerebral air embolism. One case was a cerebral arterial air embolism, w...hich had occurred due to a simple error made by a physician following coronary angiography. The other case was a cerebral venous air embolism, which was deliberately induced by venous injection of 340 ml of air. In both cases, cranial CT was performed but an accurate diagnosis was not made ; nevertheless the manner of death was recorded as natural death on both death certificates. We suggest that a physician cannot easily describe the manner of death on a death certificate when the cause of death is not certain, and that a medico-legal autopsy should definitely be performed for investigation into the cause of death in such case.
我々は,臨床医が診断なし得なかった脳空気塞栓の頭部CT画像について法医学的鑑定を行った.1例は冠動脈造影中に生じた動脈性脳空気塞栓で,施術医の単純なミスであった.もう1例は静脈に340mlの空気を注入されたことによって生じた静脈性脳空気塞栓であった.いずれも適切な診断が行われなかったにもかかわらず,死亡診断書の「死因の種類」の欄には「病死」と記載されていた.死因が不明である死体については,その原因を安易に「病死」とすることは避けなければならず,正確な死因を決定するには積極的に解剖を行うべきである.show more
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