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An Autopsy Case of Acute Massive Hematochezia Caused by Superior Mesenteric Vein Thrombosis: A First Report in Forensic Medicine
Author(s) -
Watanabe Mayumi,
Unuma Kana,
Makino Yohsuke,
Noritake Kanako,
Yamada Atsushi,
Iwase Hirotaro,
Uemura Koichi
Publication year - 2016
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.12903
Subject(s) - hematochezia , medicine , autopsy , cirrhosis , superior mesenteric vein , gastrointestinal bleeding , mesenteric vein , thrombosis , portal vein thrombosis , thrombus , surgery , gastroenterology , colonoscopy , portal vein , colorectal cancer , cancer
Superior mesenteric vein thrombosis ( SMVT ) is an uncommon cause of intestinal ischemia and massive gastrointestinal bleeding. This report describes a man with alcoholic liver cirrhosis, who died of massive hematochezia due to SMVT . A medicolegal autopsy disclosed a thrombus at the superior mesenteric vein and hemorrhagic infarction of the bowel wall, an area also within the territory of the superior mesenteric vein. Liver cirrhosis, an enlarged spleen, and esophageal varices without rupture were also observed, but ulcers and variceal bleeding were not. Other organs showed no significant findings. His blood alcohol level was 0.14% w/v. Thus, this man died from severe hematochezia associated with SMVT due to liver cirrhosis and alcohol dehydration, which can lead to coagulopathy and rapid progress of thrombus formation. This is the first report on an alternate cause for massive gastrointestinal hemorrhage with a cirrhotic patient in a forensic autopsy.