Fatal Positional Asphyxia Following Entrapment in an Inverted Body Position: Conventional Autopsy and Postmortem CT Cadaveric Examination

Background

Positional asphyxia is a form of mechanical asphyxia resulting from body positioning that interferes with adequate ventilation and venous return, ultimately leading to fatal hypoxia. Case Presentation: This report presents the case of a 45-year- old woman who died following accidental entrapment in an inverted position after falling head-first into a shallow trap-like domestic concrete structure. The unusual body position, combined with restricted thoraco-abdominal movement and impaired respiratory mechanics, led to fatal positional asphyxia. Postmortem computed tomography and conventional autopsy demonstrated pronounced signs of mechanical asphyxia, including brain and pulmonary edema, severe cyanosis of the face, intense livor mortis, and internal hemorrhages over the diaphragmatic muscle near the tendinous parts. Additional findings included bilateral nail injuries, while toxicological examination revealed no alcohol, drugs, or other toxic substances.