Mecanismo fisiopatológico de lesiones torácicas mortales desde la perspectiva médicolegal.

Abstract

Blunt chest trauma is a common cause of mortality in high-energy accidents and presents a broad spectrum of injuries that can involve bone, pulmonary, cardiac, vascular, and diaphragmatic structures. The objective of this review was to describe the pathophysiological mechanism of thoracic injuries that cause death. A search was conducted for scientific articles in PubMed, Google Scholar, SciELO, Redalyc, Medigraphic, and healthcare-related websites published between 2018 and 2025, using descriptors related to chest trauma, lethal injuries, and postmortem findings. The literature review identified the injuries most frequently linked to fatal outcomes as massive hemothorax, tension pneumothorax, extensive pulmonary contusion, traumatic rupture of the thoracic aorta, hemopericardium, and cardiac and tracheobronchial injuries. These injuries can develop immediately or later, and in many cases present no obvious external signs, requiring a thorough postmortem examination. It is concluded that the pathophysiological mechanism of fatal thoracic injuries varies according to the type, location, and severity of the injuries. They generally produce pulmonary dysfunction and hemodynamic instability, thus endangering life and potentially leading to immediate or delayed death due to complications. From a forensic perspective, analyzing this mechanism allows thoracic injuries to be determined or ruled out as a direct cause of death.