Fatal thoracic impalement on postmortem imaging

In the present paper, the authors describe a case of fatal thoracic impalement in a victim of a road traffic accident, by penetration of a metal handrail. The driver lost control of his car while overtaking three cars. Due to the force of the vehicle collision with a metal railing, the upper cross bar penetrated the front of the car and subsequently the driver was pierced by the center-pillar in the car. Death occurred at the scene of the accident. Postmortem, computed tomography, computed tomography angiography and a magnetic resonance tomography were performed and revealed severe heart destruction and hemorrhage as cause of death. The present case report shows that postmortem imaging might have value as a screening method to decide whether arising forensic questions can be answered just by imaging like in the presented case or if further examinations such as conventional autopsy are required.