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Bilateral spontaneous pneumothorax secondary to aspiration pneumonia induced by a wristwatch lodged at the pharyngoesophageal junction

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Abstract

Bilateral spontaneous pneumothorax secondary to disease is rare and seldom encountered in forensic autopsies; however, traumatic bilateral pneumothorax occurs often. Herein, we present a forensic case involving a 50-year-old woman who died 4 days after ingesting a wristwatch. Postmortem computed tomography and autopsy findings demonstrated that the wristwatch was lodged at the pharyngoesophageal junction, that she had a bilateral pneumothorax unaccompanied by any thoracic wound, and that macular hemorrhagic lesions on the lung surfaces were responsible for the pneumothorax. A histological examination of the macular lesions revealed that they were aspiration pneumonia foci with many birefringent foreign materials. Furthermore, a necrotic process secondary to aspiration pneumonia with a one way check-valve hyperinflation caused by foreign materials in the bronchioles was the most probable pathogenesis of her pneumothorax. To our knowledge, this is the first reported case of a bilateral secondary spontaneous pneumothorax caused by a large foreign body at the pharyngoesophageal junction leading to death.

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Acknowledgments

We are grateful for the helpful support provided by Dr. Tokiko Ishida, BSs Hirozo Minami, and Hitoshi Abiru during the autopsies and preparation of the histological specimens.

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Authors and Affiliations

  1. Department of Forensic Medicine, Kyoto University Graduate School of Medicine, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan

    Chihiro Kawai, Masashi Miyao, Hirokazu Kotani & Keiji Tamaki

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  1. Chihiro Kawai
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  2. Masashi Miyao
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  3. Hirokazu Kotani
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  4. Keiji Tamaki
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Correspondence to Hirokazu Kotani.

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Kawai, C., Miyao, M., Kotani, H. et al. Bilateral spontaneous pneumothorax secondary to aspiration pneumonia induced by a wristwatch lodged at the pharyngoesophageal junction. Forensic Sci Med Pathol 11, 249–254 (2015). https://doi.org/10.1007/s12024-015-9663-y

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  • DOI: https://doi.org/10.1007/s12024-015-9663-y

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