The fatal outcome of an individual with anorexia nervosa and Sheehan's syndrome as a result of acute enterocolitis: A case report

Objectives: To illustrate the close association between a disturbed psychosocial up‐bringing, frequent physical illness, and medical interventions. Method: We report a case of a 44‐year‐old woman with anorexia nervosa (AN) and Sheehan's syndrome who died as a result of a toxic cardiac arrest. Results: The patient presented with a BMI of 13.6 kg/m 2 . She refused any intensive‐care treatment and died from toxic cardiac arrest. Postmortem examination revealed an acute gastroenterocolitis. Discussion: The history of this patient illustrates how psychological deprivation led to eating disturbances, early pregnancy, and the life‐threatening delivery of twins. This resulted in a diagnosis of Sheehan's syndrome, hepatitis C, and a ventricular ulcer. A psychosocial event triggered a late exacerbation of her AN. A helpful alliance between patient and staff did not occur as she rejected it. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2010.