Acute aortic dissection diagnosed after embalming: macroscopic and microscopic findings.

Details

Serval ID
serval:BIB_1CF09B101D55
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
Acute aortic dissection diagnosed after embalming: macroscopic and microscopic findings.
Journal
Journal of Forensic Sciences
Author(s)
Savall F., Dedouit F., Piercecchi-Marti M.D., Leonetti G., Rougé D., Telmon N.
ISSN
1556-4029 (Electronic)
ISSN-L
0022-1198
Publication state
Published
Issued date
2014
Peer-reviewed
Oui
Volume
59
Number
5
Pages
1423-1426
Language
english
Notes
Publication types: Case Reports ; Journal ArticlePublication Status: ppublish
Abstract
A 58-year-old man died suddenly in Madagascar and poisoning was suspected. The body was embalmed after death and the general state of preservation was good. We found a major aortic dissection with a large false lumen from the aortic root to the common iliac arteries and a hemopericardium with formalinized blood clot. The intimal tear was on the ascending aorta, and an intramural hemorrhage was noted at the right coronary artery, attesting to a retrograde dissection. Microscopic studies confirmed aortic dissection with extensive intramural hemorrhage and also confirmed the retrograde dissection to the right coronary artery with a reduction of 90% of the true lumen. Classically, aortic dissection occurs in individuals with hypertension and individuals with genetic disorders of collagen formation. The diagnosis is often first established at the postmortem examination. Aortic dissection is therefore dealt with largely in necropsy studies. The usual cause of death is rupture into the pericardial sac. One case of bloodless dissection has been reported but the sudden death was explained by acute myocardial ischemia secondary to dissection of the left coronary artery. In our case, we found major hemopericardium and also intramural hemorrhage at the right coronary artery. We were able to make the diagnosis of aortic dissection and exclude the suspicion of homicide 15 days after death and after embalming.
Keywords
Aorta/injuries, Aorta/pathology, Cardiac Tamponade/etiology, Coronary Vessels/injuries, Coronary Vessels/pathology, Embalming, Forensic Pathology, Hemorrhage/pathology, Humans, Male, Middle Aged, Pericardial Effusion/pathology, Tunica Intima/injuries, Tunica Intima/pathology
Pubmed
Web of science
Create date
12/01/2016 11:50
Last modification date
20/08/2019 12:53
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