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In a foreign country, a religious terrorist group raided a restaurant, using pipe bombs, sharp-edged weapons, and various types of firearms (handguns, submachine guns, and AK-47 assault rifles) loaded with normal and prohibited bullets to kill foreigner customers, some of whom were Italian tourists. Local pathologists performed forensic autopsies on the bodies, but we were asked to perform additional external examinations, postmortem computed tomography (PMCT) scans, and then a second round of complete autopsies on nine victims (5 females and 4 males). Four victims had slash wounds inflicted by sharp-edged weapons, mostly localized in the head and neck. All but two victims had gunshot wounds. Finally, three casualties had injuries caused by the explosion of improvised explosive devices. In all cases, PMCT was a reliable source of information and provided strategic guide during autopsies, helping identify and describe the injuries and thus reconstruct the events. Therefore, in these cases, we suggest integrating the autopsy findings with the postmortem radiological data.

Nowadays, the modern computed tomography techniques are more and more applied in forensic investigations. The detection of abnormalities in post-mortem computed tomography (PMCT) imaging of the lungs is very common. As in clinical imaging, also in post-mortem imaging the right interpretation of alterations has an extreme importance for the assessment of correct conclusions. This is even crucial when the radiologist who approaches the PMCT images is not routinely involved in forensic cases. The aim of this article is to provide radiologists who approach PMCT imaging cases with some indications for a proper and correct interpretation of pulmonary findings, to avoid misleading forensic conclusions. Particularly, the following issues will be addressed: PMCT imaging of post-mortem changes of the lungs; PMCT imaging of pathological lungs [(a) in thoracic trauma cases, (b) in cases without thoracic trauma]. Finally, the possible pitfalls in interpretation of PMCT imaging of the lungs will be also discussed.

Objective: Although postmortem CT suffices for diagnosing most forms of traumatic death, the examination of natural death is, to date, very difficult and error prone. The introduction of postmortem angiography has led to improved radiologic diagnoses of natural deaths. Nevertheless, histologic changes to tissues, an important aspect in traditional examination procedures, remain obscure even with CT and CT angiography. For this reason, we examined the accuracy of a minimally invasive procedure (i.e., CT angiography combined with biopsy) in diagnosing major findings and the cause of death in natural deaths., Materials and Methods: We examined 20 bodies in a minimally invasive fashion-namely, native CT, CT angiography, and biopsy-and compared the results to those obtained at subsequent autopsy and histologic analysis., Results: Regarding the major findings and the cause of death, the minimally invasive examination showed almost identical results in 18 of 20 cases. In one case, the severity of a cardiac ischemia was underestimated; in another case, the iliopsoas muscles were not biopsied, thus missing the diagnosis of discoid muscle necrosis and therefore a death due to hypothermia., Conclusion: In light of increasing objections of the next of kin toward an autopsy and the necessity for medical examiners to assess the manner and cause of death, we think that the minimally invasive procedure described here may present a viable compromise in selected cases.