ArticleThe British journal of radiology2018
The gas bubble sign-a reliable indicator of laryngeal fractures in hanging on post-mortem CT.
Article in The British journal of radiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.
- Relevant findings on postmortem CT and postmortem MRI in hanging, ligature strangulation and manual strangulation and their additional value compared to autopsy - a systematic review.Forensic science, medicine, and pathology · 2019Pooled it
- Medico-legal interpretations of gas on postmortem CT: a scoping review.International journal of legal medicine · 2026Article
- Comparison of autopsy and stereomicroscope findings in the examination of hyoid bone fractures.Forensic science, medicine, and pathology · 2026Article
- Death by hanging: possibilities and limits of medico-legal evidence.International journal of legal medicine · 2026Review
- A scoping review of strangulation and hanging: determining suicide from concealed homicide in equivocal death cases.Psychiatry, psychology, and law : an interdisciplinary journal of the Australian and New Zealand Association of Psychiatry, Psychology and Law · 2026Article
- Article
- Forensic homicidal strangulation in women: Case series and systematic literature review.Forensic science international. Synergy · 2025Article
- Postmortem CT: Applications in Clinical and Forensic Medicine.Radiographics : a review publication of the Radiological Society of North America, Inc · 2025Review
- The current state of forensic imaging - post mortem imaging.International journal of legal medicine · 2025Review
- Diagnostic Utility of the "Air Sign" as a Radiological Indicator for Mandibular Body and Angle Fractures.Journal of clinical medicine · 2024Article
- A Case of Hanging with Limited Specific Postmortem Brain Imaging.NMC case report journal · 2024Article
- CT Findings in Laryngeal Trauma and the Clinical Implications.Clinical neuroradiology · 2023Article
- Comparison of findings identified at traditional invasive autopsy and postmortem computed tomography in suicidal hangings.International journal of legal medicine · 2022Article
- Incidence and factor analysis of laryngohyoid fractures in hanging individuals-computed tomography study.European radiology · 2021Article
- The added value of postmortem magnetic resonance imaging in cases of hanging compared to postmortem computed tomography and autopsy.Forensic science, medicine, and pathology · 2020Article
- Post-Mortem Immunohistochemical Evidence of β2-Adrenergic Receptor Expression in the Adrenal Gland.International journal of molecular sciences · 2019Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe purpose was to evaluate the presence of gas in the tissue adjacent to the laryngeal structures, "the gas bubble sign", in cases of hanging as a diagnostic indicator of neck trauma.
methodsIn this study, post-mortem CT (PMCT) scans and autopsies of 35 victims of hanging were examined to reveal age-dependent changes, laryngeal fracture, fracture location and the presence of gas. A matched group with cardiac arrest or intoxication was used as controls (n = 35). An autopsy was performed in each case.
resultsIncomplete suspension was the most common method in hanging. The thyroid horns (90.5%) were identified as the most vulnerable location for fractures. Laryngeal deformity and dislocation, which was only detected on PMCT, was observed in 57.1% and was concomitant with fractures in 83.3%. Laryngeal fractures are more common with advanced age (>40 years, 88.9%) and less common in younger subjects (<40 years, 29.4%). The gas bubble sign with regard to laryngeal fractures yielded a sensitivity of 79.2%, a positive predictive value of 95%, a specificity of 90.9%, a negative predictive value of 34.5% and an accuracy of 83%.
conclusionThe complex evaluation of the larynx is profoundly supported by PMCT and the detection of the gas bubble sign as a diagnostic indicator of neck trauma. This relevant diagnostic finding might aid in not only post-mortem cases but also clinical cases, for patients who survive an assault to the neck. Advances in knowledge: (1) The gas bubble sign is a diagnostic indicator of neck trauma in not putrefied bodies. (2) PMCT supports evaluation of trauma to the neck in hanging tremendously. (3) The diagnostic finding of gas located at the laryngeal structures may not only aid in post-mortem cases but also clinical cases of people who survive an assault to the neck.
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