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  • 1
    Electronic Resource
    Electronic Resource
    Infektiöse ulcero-polypöse Endokarditis mit Perforation der Aorten- und Mitralklappe Klinik und pathologisch-anatomischer Obduktionsbefund einer Linksherzendokarditis durch koagulasenegative Staphylokokken (1997)
    Springer
    Rechtsmedizin 7 (1997), S. 189-192 
    Details
    ISSN: 1434-5196
    Keywords: Key words Infective endocarditis ; Coagulase-negative ; staphylococci ; Aortic valve ; Mitral valve ; Perforation ; Pathology ; Schlüsselwörter Infektiöse Endokarditis ; Koagulasenegative Staphylokokken ; Aortenklappe ; Mitralklappe ; Perforation ; Pathologie
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Description / Table of Contents: Zusammenfassung Berichtet wird über den plötzlichen Tod eines 64jährigen Mannes, der innerhalb einer Stunde nach stationärer Aufnahme, die aufgrund respiratorischer Insuffizienz erfolgte, unerwartet verstarb. Erst postmortal wurde per obductionem eine Linksherzendokarditis mit Perforation der Aorten- und Mitralklappe als Todesursache ermittelt. Als Erreger wurden koagulasenegative Staphylokokken nachgewiesen. Eine infektiöse Endokarditis nativer Klappen durch koagulasenegative Staphylokokken ist ein eher seltenes Ereignis. Die makromorphologischen und histologischen Befunde werden vorgestellt und diskutiert.
    Notes: Abstract We report on a 64-year-old man who died within 1 h after admission to hospital with symptoms of respiratory insufficiency. Autopsy showed as cause of death a clinically unknown coagulase-negative staphylococci-induced left-sided endocarditis with perforation of the aortic and mitral valve. Infective endocarditis by coagulase-negative staphylococci in native valves is a rare event. The macroscopic appearance and histological findings are presented and discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001940050012
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  • 2
    Electronic Resource
    Electronic Resource
    Ulcus ventriculi und duodeni als Ursache des plötzlichen, unerwarteten Todes (1999)
    Springer
    Rechtsmedizin 9 (1999), S. 81-85 
    Details
    ISSN: 1434-5196
    Keywords: Key words Gastric ulcer ; Duodenal ulcer ; Bleeding ; Perforation ; Haematemesis ; Melaena ; Sudden death ; Schlüsselwörter Ulcus ventriculi ; Ulcus duodeni ; Blutung ; Perforation ; Hämatemesis ; Melaena ; Plötzlicher Tod
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Description / Table of Contents: Zusammenfassung Es erfolgte die retrospektive Auswertung der im Zeitraum von 1991–1997 am Institut für Rechtsmedizin der Universität Hamburg durchgeführten 6962 gerichtlichen und wissenschaftlichen Obduktionen hinsichtlich erst autoptisch identifizierter gastroduodenaler Ulzera als Ursache des plötzlichen, unerwarteten Todes. Dabei fanden sich 25 Fälle (58%) mit tödlicher Blutung, 16 Fälle (37%) todesursächlicher Perforation und 2 Fälle mit einer Koinzidenz von Blutung und Perforation. Insgesamt lag die Prävalenz letaler Komplikationen gastroduodenaler Ulzera im untersuchten Sektionsgut bei 0,62%. Folgende Aspekte sind hervorzuheben: Als Ursache des plötzlichen, unerwarteten Todes betreffen gastroduodenale Ulzera vorwiegend ältere Menschen (Durchschnittsalter der Betroffenen im untersuchten Obduktionsgut 62,2 Jahre), Angehörige sozialer Randgruppen und Abhängigkeitskranke (vorrangig Alkoholabusus). Bei fehlenden oder atypischen Krankheitssymptomen kommt es nicht selten zu ärztlichen Fehleinschätzungen der vitalen Bedrohung und unzureichender medizinischer Diagnostik.
    Notes: Abstract A retrospective review of 6962 autopsies carried out at the Institute of Legal Medicine (University of Hamburg) during 1991–1997 was performed to identify previously unknown peptic ulcer disease as the cause of sudden, unexpected death. During this period 25 cases (58%) of fatal acute bleeding, 16 cases (37%) of fatal peptic ulcer perforation and 2 cases of coincident bleeding and perforation occurred. The following aspects are emphasized: as the cause of sudden, unexpected death peptic ulcer disease mainly affects elderly people (average of the afflicted in the reviewed autopsy series 62.2 y), members of social fringe groups and addicts (predominately alcoholics). In cases of absent or atypical symptoms, preceding false medical appraisal of the life-threatening severity of the disease and insufficient diagnoses can be frequently found.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001940050085
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Non-traumatic liver rupture due to a perforated gastric ulcer (1999)
    Springer
    International journal of legal medicine 112 (1999), S. 321-323 
    Details
    ISSN: 1437-1596
    Keywords: Key words Liver rupture ; Non-traumatic gastric ulcer ; Perforation ; Complication ; Perihepatic abscess
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Law
    Notes: Abstract The case of a 57-year-old woman with a fatal liver rupture due to a necrotizing perihepatic abscess caused by a perforated gastric ulcer is presented. The ulcer had been treated successfully by surgical intervention 8 days before. The autopsy revealed a large perihepatic abscess and multiple ruptures of Glisson’s capsule with a large subcapsular hematoma and underlying lacerations of the liver parenchyma. The patient had no history of previous abdominal trauma and the known etiological factors for spontaneous liver rupture were excluded by the autopsy findings or by clinical and laboratory data. No liver penetration by the gastric ulcer was found at autopsy and there were no clinical signs or symptoms for an infection or any degenerative or inflammatory diseases. Histologically abundant vegetable fibers, identified as stomach contents and a dense infiltrate of lymphocytes and granulocytes were found in the perihepatic abscess next to Glisson’s capsule. Below Glisson’s capsule there were hemorrhages, focal hepatocellular necrosis and a mixed cell inflammatory infiltration. In the present case, preceding perforation of the gastric ulcer with leaking of gastric acid into the peritoneal cavity resulted in peptic digestion of Glisson’s capsule. Vascular lesions of the affected parts of Glisson’s capsule and the liver parenchyma underneath resulted in intrahepatic hemorrhage and an increase in intrahepatic pressure with subsequent liver rupture. To the authors’ knowledge no similar case of spontaneous liver rupture due to perforation of a gastric ulcer has been reported previously.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004140050259
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    Paper (German National Licenses)
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