Right coronary artery ectasia with a focal aneurysm in a decomposed body: Non-contrast postmortem CT and autopsy correlation

Herein, we present a case involving a markedly decomposed body in which non-contrast postmortem computed tomography (PMCT) demonstrated long-segment right coronary artery ectasia with focal aneurysmal dilatation. A man estimated to be in his 30s was found dead 12 days after he had last been confirmed alive. PMCT showed extensive decomposition-related gas and identified a conspicuously dilated segment along the anatomical course of the right coronary artery. Curved planar reformations showed that the dilated segment measured approximately 106 mm in length. Autopsy confirmed focal aneurysmal dilatation of the right coronary artery and cardiomegaly. Dark red intraluminal material was present in one cross-section, but advanced decomposition and autolysis precluded confirmation of antemortem thrombosis or acute myocardial infarction. This case illustrates the value and limitations of non-contrast PMCT for documenting coronary morphology in markedly decomposed bodies.