Link: http://www.ncbi.nlm.nih.gov/pubmed/26594002

Leg Med (Tokyo). 2015 Nov;17(6):521-4. doi: 10.1016/j.legalmed.2015.10.010. Epub 2015 Nov 6.
Possibility of visualization of gastrothorax based on unenhanced postmortem computed tomography/PMCT.
Okuda T1, Shiotani S2, Kobayashi T3, Hayakawa H4, Ohno Y5.
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Abstract
We present a fatal case of a gastrothorax due to an acute gastric volvulus resulting from a Bochdalek hernia. A 5-year-old boy without previous medical history was brought to our institution in a state of cardiopulmonary arrest and was subsequently pronounced dead. Postmortem computed tomography (PMCT) of the torso showed abdominal organs involving the lower section of the esophagus up to the entire stomach, the left side of the transverse colon, the entire spleen, and the tail of the pancreas herniated into the left thoracic cavity. The stomach was markedly expanded and a mesentero-axial (rotation along the short axis) volvulus was observed, displacing mediastinal structures to the right side and depressing the diaphragmatic contour. A PMCT of the thorax at the lung window setting revealed displacement of bilateral lungs. The bilateral lungs were severely atelectatic and congested. The PMCT findings mentioned above were consistent with the autopsy findings. PMCT can provide useful information for the diagnosis in cases we initially cannot predict any significant changes, for example, organ displacement.

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KEYWORDS:
Congenital diaphragmatic hernia; Forensic pathology; Gastric volvulus; PMCT; Sudden death; Tension gastrothorax