Abstract

GARFIA, A.; SALGUERO, M.; MARTINEZ, M.C.  and  PIMENTEL, J.C.. Cause and Manner of Death Undetermined: regarding a case of sudden death in an adolescent with an intestinal cystic tumour, discovered during autopsy. Cuad. med. forense [online]. 2002, n.28, pp.49-57. ISSN 1988-611X.

We present a case of sudden and unexpected death in a 19 year-old, who in the hours prior to his death presented a clinical picture of dizziness, nausea and vomiting which was treated at the First-Aid Centre with analgesics and antispasmodics. After a few hours the patient was again taken to the Medical Centre by his relatives, by then unconscious. In spite of resuscitation measures the patient presented cardio-respiratory arrest and death. During the forensic autopsy the existence of a mesenteric tumour was discovered in the distal ileum. The corpse gave off a peculiar smell which reminded the pathologist of the typical smell of some organophosphorous pesticides. The following diagnoses for the cause of death were put forward in the pathologists report: 1) Septic shock due to intestinal abscess. 2) Mortal poisoning by pesticides. 3) Sudden cardiac death. The chemical-toxicological investigation resulted negative. The histopathologic study did not show cardiac lesions which could justify the death, and the study of the mesenteric tumour showed that it was a cystic intestinal duplication, with discreet chronic inflammation of the wall; ulcerations, haemorrhage, vascular or ischaemic intestinal lesions which could have justified sudden death with digestive causes, were not seen. The cause and manner of death were considered undetermined.

Keywords : sudden death; cause and manner of death; intestinal duplication; forensic pathology; forensic autopsy.

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