Multi-slice computed tomography (MSCT) of mountaineering casualties in the Swiss Alps – Advantages and limitations

Steffen, Ross; Suter, Cosima; Patricia, Flach; Lars, Oesterhelweg; Michael, Thali; Stephan, Bolliger

doi:10.1016/j.legalmed.2010.06.002

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Volume 12, Issue 6 , Pages 271-275, November 2010

Multi-slice computed tomography (MSCT) of mountaineering casualties in the Swiss Alps – Advantages and limitations

Ross Steffen
- Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland
- Corresponding author. Tel.: +41 31 631 84 11; fax: +41 31 631 38 33.
Cosima Suter
- Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland
Flach Patricia
- Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland
- Departement of Neuroradiology, Inselspital Bern, University of Bern, CH-3010 Bern, Switzerland
Oesterhelweg Lars
- Institute of Legal Medicine and Forensic Sciences, Charite-Universitätsmedizin Berlin D-10559, Germany
Thali Michael
- Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland
Bolliger Stephan
- Centre for Forensic Imaging and Virtopsy, Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland

Received 5 October 2009; received in revised form 19 April 2010; accepted 6 June 2010. published online 23 August 2010.

Abstract

As an Alpine country, Switzerland has not only a thriving mountaineering tourist industry, but also many mountaineering casualties. At the request of the state attorney, most of the victims undergo only an external inspection without autopsy. One of the main tasks of the forensic pathologist under these circumstances is the correct identification of the deceased for a fast release to their kin. Nevertheless, detailed knowledge of the injuries sustained may lead to improved safety measures, such as better protective equipment.

In this study, we examined the feasibility of using cross-sectional imaging with postmortem multi-slice computed tomography (MSCT) to detect lesions of the skeletal structures and internal organs. For this purpose, we used whole-body MSCT to examine 10 corpses that suffered fatal falls from great height while climbing in the Swiss part of the European Alps from the years 2007 to 2009.

We conclude that postmortem CT imaging is a valuable tool for dental identification and is superior to plain X-rays as a viable compromise between a solely external legal inspection and an autopsy because it delivers otherwise irretrievable additional internal findings non-invasively. This fact is of great importance in cases where an autopsy is refused.

Keywords: Mountaineering casualties, Blunt trauma, Postmortem computed tomography, Virtopsy