Document Detail


Congenital mesenteric defects and unexpected death-a rare finding at autopsy.
MedLine Citation:
PMID:  18205527     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Gastrointestinal causes of sudden and/or unexpected death in the young are uncommon and only rarely involve congenital anomalies of the mesentery. Two cases are reported of unexpected deaths following herniation of intestine through congenital mesenteric defects to illustrate the forensic issues that may arise. Case 1 involves a 2.5-year-old girl who collapsed on arrival to hospital following 18 hours of fever and apparently mildly nonspecific symptoms. Resuscitation was unsuccessful, and at autopsy a segment of gangrenous small intestine was found that had herniated through a congenital mesenteric defect. Case 2 involves a 23-year-old woman with a past history of severe mental and physical disabilities who was found dead in her bed. She had a recent history of mild diarrhea and vomiting, but had not appeared particularly ill. At autopsy the peritoneal cavity was filled with a very dilated and obstructed colon as a result of herniation of a segment of sigmoid colon through a distal small intestinal mesenteric defect. These cases demonstrate that symptoms and signs of intestinal ischemia may not be clearly manifested in early childhood and that developmental delay may also result in older individuals presenting in a nonspecific manner. Although rare, congenital mesenteric abnormalities with compromise of the intestinal vasculature remain a possibility to be considered at autopsy in all cases of unexpected death, despite the lack of a clear history of significant gastrointestinal disturbance. Death may relate to ischemic compromise of either the herniated portion of intestine (as in case 1) or to the stretched intestine bordering the hernial orifice (as in case 2).
Authors:
Roger W Byard; Regula Wick
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2008-01-18
Journal Detail:
Title:  Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society     Volume:  11     ISSN:  1093-5266     ISO Abbreviation:  Pediatr. Dev. Pathol.     Publication Date:    2008 May-Jun
Date Detail:
Created Date:  2008-06-16     Completed Date:  2008-08-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9809673     Medline TA:  Pediatr Dev Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  245-8     Citation Subset:  IM    
Affiliation:
Discipline of Pathology, The University of Adelaide, Adelaide, South Australia, Australia. byard.roger@saugov.sa.gov.au
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MeSH Terms
Descriptor/Qualifier:
Adult
Autopsy
Child, Preschool
Death, Sudden / etiology*
Developmental Disabilities / complications
Female
Hernia, Abdominal / etiology
Humans
Intestines / pathology
Mental Disorders / complications
Mesentery / abnormalities*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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