Radiographic demonstration of esophageal and tracheal fistulas at autopsy using a contrasting medium that vulcanizes at room temperature

• Published in: Journal of forensic sciences Vol. 36; no. 4; p. 1129
• Main Authors: Karhunen, P J, Lalu, K
• Format: Journal Article
• Language: English
• Published: United States 01-07-1991
• Subjects: Aged; Aged, 80 and over; Aortic Diseases - diagnostic imaging; Autopsy; Brachiocephalic Trunk; Contrast Media; Female; Fistula - diagnostic imaging; Humans; Lead; Male; Middle Aged; Oxides; Radiography; Silicones; Temperature; Tracheal Diseases - diagnostic imaging; Tracheoesophageal Fistula - diagnostic imaging
• ISSN: 0022-1198
• DOI: 10.1520/JFS13128J

Esophageal and tracheal fistulas, which occur in 0.05% of medicolegal autopsies, were demonstrated in three cases by a postmortem radiographic technique using silicone rubber/lead oxide as a contrasting medium that vulcanizes at room temperature. In one 83-year-old male, a tracheoesophageal fistula was detected, which had developed after surgical repair of an esophageal rupture caused by a flexible fiberoptic endoscope. In a second case, carcinoma of the esophagus in a 78-year-old male had eroded the trachea and arcus of the aorta creating a fatal tracheoesophagoaortic fistula. In a third case, 55-year-old female developed a tracheobrachicephalic artery fistula as a result of an infiltrating cystic adenocarcinoma of the trachea, resulting in a fatal hemorrhage into the trachea. The results of this study indicate that diagnostic radiologic methods using a vulcanized contrasting medium are useful in supplementing normal dissection in autopsy cases with suspected fistulas of the esophagus or trachea.