[The relevance of spontaneous ruptures of the aorta in forensic medicine (author's transl)]

Abstract

Report on 42 cases of "spontaneous rupture of the aorta" (0.4% of the examined autopsies in the case of 9817 court-ordered post mortem examinations, or 1.4% of the deaths by "natural causes"). The ratio of sexes male to female was 2:1. The cause of changes in blood vessels were arteriosclerosis (53.6%) and medionecrosis (31.7%). In 57.1% of cases, ruptures were in the ascending part, in 11.9% in the arch, in 7.1% in the thoracic descending part and in 21.4% in the abdominal descending part. With the exception of 3 cases with incomplete rupture and death due to circulation failure, the commonest causes of death were pericardial tamponade or hemorrhage into the thoracic or abdominal cavity. In 6 cases (1 X arteriosclerosis, 5 X medionecrosis) the question had to be examined as to whether external influences were only an initiating factor or whether they constituted a legally relevant cause for the rupture and subsequent death. In 4 cases such a relationship was ruled out after examination of the circumstances and autopsy findings. In 2 cases (cases 3 and 4) the role of an external influence could not be ruled out for the moment. The penal and insurance problems are discussed in depth on the basis of the literature.