The Feasibility of Computerized Tomography in Standard Forensic Autopsy Lightning Cases

Objectives: This study determined the value of whole body computerized tomography with 3D reconstruction and volume rendering in the forensic investigation of five fatal lightning strike cases. Materials and methods: We conducted a prospective study on all lightning deaths presenting to the Pretoria Medico-Legal Laboratory from 1st June 2013 to 1st June 2016. Five fatal lightning strike cases were submitted for forensic medical examination and had whole body computerized tomography with 3D reconstruction and volume rendering prior to medicolegal autopsy examination. All data were treated confidentially. Results: CT detected additional abnormalities in the brain, neck, gastrointestinal and genitourinary tracts, including underlying pre-existing disease compared to standard autopsy. Conclusion: CT with 3D reconstruction and volume rendering in lightning-related deaths, in conjunction with conventional autopsy yielded more significant and relevant findings than CT or autopsy alone. Spinal injuries (C1/C2) and a far more widespread documentation of barotrauma, especially of the lungs may be seen as a refinement of current knowledge. In general, with lightning-related deaths, where there are medicolegal implications, CT and standard autopsy should be performed together for optimal information.