PMC6170213_01
Operative findings.. Complete transection of the left main bronchus (A, proximal, white arrowhead; distal, white arrow) and left superior pulmonary vein (A, blue arrows), and severe contusion to the left superior lobe (B).
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The site of air exit was explored, and complete transection of the left main bronchus (Fig. 1A) was discovered. In front of the transected bronchus, the complete transected left superior pulmonary vein (Fig. 1A) and severe contusion to the left superior pulmonary lobe were also confirmed (Fig. 1B).
Postmortem computed tomography.. Air in the left ventricle (A), the aortic arch (B), the descending aorta (C), the bilateral common carotid arteries (D, red arrowheads) and bilateral subclavian arteries (D, red arrows). Disrupted left main bronchus (E, proximal, red arrowhead; distal, red arrow). Air bubbles in the bilateral external iliac arteries (F). The 3D volume-rendered images demonstrate a large amount of air (G/H, blue region, vessel lumen replaced by air).
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CT scan showed multiple skull fractures including the skull base and facial bones and extensive pneumocephalus. Chest CT scan revealed extensive air in the left ventricle (Fig. 2A), the aortic arch (Fig. 2B), the descending aorta (Fig. 2C), and great vessels including the brachiocephalic trunk, bilateral common carotid arteries, and bilateral subclavian arteries (Fig. 2D). The left main bronchus was disrupted (Fig. 2E). Air bubbles were also observed in the abdominal aorta, the celiac artery, the superior mesenteric artery, and bilateral common, internal, and external iliac arteries (Fig. 2F). The volume rendering technique was employed to create 3D images, which demonstrated air in the ascending aorta, aortic arch, and great vessels (Fig. 2G, H).