Traumatic asphyxial deaths in car crush: Report of 3 autopsy cases

Traumatic asphyxia is a rare syndrome due to compression of thorax, abdomen or both. The diagnosis of traumatic asphyxia is based on typical findings consisting of cervico-facial congestion with swelling, multiple petechial hemorrhages in skin and conjunctiva with a history of traumatic compression. The authors report three cases of traumatic asphyxia in car crash to illustrate few unusual findings along with the typical autopsy findings. All three cases showed the typical findings of traumatic asphyxia. Regarding unusual findings, blisters containing hemorrhagic fluid were observed in two cases over areas subjected to traumatic compression. One case showed the peculiar skin pattern in the form of absent congestion corresponding to the tight-fitting strap of banyan. Subcutaneous emphysema was noted in two cases in presence of intact visceral pleura. These unusual findings could be used as additional markers of traumatic asphyxia in conjunction with characteristic features to support the diagnosis of traumatic asphyxia.