Sudden death caused by tension pneumothorax after rupture of a thoracic aortic aneurysm - Case report

A rare case of fatal tension pneumothorax is reported. An aged Japanese man with marked subcutaneous emphysema of the neck was found collapsed in a be tting office. He was ascertained to have left tension pneumothorax, based o n radiographic examinations carried out before his death. At autopsy, sever e pneumomediastinum. was observed, and the descending thoracic aorta with a ruptured dissecting aneurysm was closely adhered to the left lung pleura. The hemorrhage spread into the pulmonary parenchyma and finally spouted out from the surface of the lung apex. Because the blood loss itself was not f atal in quantity, it is concluded that the patient died of tension pneumoth orax caused by a lung penetration from the rupture of an aortic aneurysm.