Bell M D
Broward County Medical Examiner's Office, University of Miami School of Medicine, Department of Pathology, Fort Lauderdale, FL.
J Forensic Sci. 1992 Sep;37(5):1401-6.
A 45-year-old white man was hospitalized with gross hematuria, one month after cystoscopy and biopsy for the same complaint. The biopsy revealed cystitis glandularis. One day after admission, he developed seizures and died within hours. Autopsy, laboratory tests, and further questioning of the hospital staff showed that he died of acute hyponatremia and massive intravascular hemolysis after irrigating the bladder with sterile water. Two deep bladder ulcers with exposed veins served as the portals of entry. Until now, this fatal complication had been described only during transurethral surgery. Both a careful autopsy and hospital investigation is necessary to differentiate in-hospital natural death from iatrogenic fatality.
一名45岁的白人男性因肉眼血尿入院，一个月前因同样症状接受了膀胱镜检查和活检。活检显示为腺性膀胱炎。入院一天后，他出现癫痫发作并在数小时内死亡。尸检、实验室检查以及对医院工作人员的进一步询问表明，他在用无菌水冲洗膀胱后死于急性低钠血症和大量血管内溶血。两个深部膀胱溃疡伴静脉暴露成为了感染入口。到目前为止，这种致命并发症仅在经尿道手术中被描述过。进行仔细的尸检和医院调查对于区分院内自然死亡和医源性死亡都是必要的。
