An atypical case of fatal ‘esophageal apoplexy’: post-mortem findings and differential diagnosis

Forensic pathologists need to have comprehensive knowledge of a large variety of causes of sudden natural death. We describe a case of sudden and unexpected death in woman in her sixties due to rupture of a large paraesophageal hematoma. The post-mortem examination and differential diagnosis are dis...

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Bibliographic Details
Published in:International journal of legal medicine 2024-11, Vol.138 (6), p.2351-2355
Main Authors: de Boer, Hans H., O’Donnell, Chris
Format: Article
Language:English
Subjects:
Autopsies
Case Report
Computed tomography
Death, Sudden - etiology
Diagnosis
Diagnosis, Differential
Esophageal Diseases - diagnostic imaging
Esophageal Diseases - pathology
Esophagus
Esophagus - diagnostic imaging
Esophagus - pathology
Female
Forensic Medicine
Forensic pathology
Hematoma
Hematoma - diagnostic imaging
Hematoma - pathology
Hemorrhage
Histology
Humans
Literature reviews
Medical diagnosis
Medical Law
Medicine
Medicine & Public Health
Middle Aged
Rupture, Spontaneous
Tomography, X-Ray Computed
Citations: Items that this one cites
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Summary:Forensic pathologists need to have comprehensive knowledge of a large variety of causes of sudden natural death. We describe a case of sudden and unexpected death in woman in her sixties due to rupture of a large paraesophageal hematoma. The post-mortem examination and differential diagnosis are discussed. The combined findings of whole-body post-mortem CT imaging (PMCT), targeted PMCT angiography, autopsy, and histology are most in keeping with ‘esophageal apoplexy’; a rare cause of hemorrhage in the esophageal wall. A review of the literature indicates that most cases of esophageal apoplexy are self-limiting and that fatal complications are exceedingly rare. Our case demonstrates that esophageal apoplexy can present as sudden unexpected death.
ISSN:0937-9827
1437-1596
1437-1596
DOI:10.1007/s00414-024-03280-6