Discipline of Anatomy and Pathology, The University of Adelaide, Frome Road, Level 2 Helen Mayo Building North, Adelaide, 5005, Australia.
Forensic Sci Med Pathol. 2020 Jun;16(2):370-372. doi: 10.1007/s12024-019-00191-6. Epub 2019 Oct 22.
A 66-year-old man was found dead at his home address. He had a history of poor nutrition with recent episodes of vomiting. At autopsy the decedent was cachexic with a body mass index (BMI) of 16.1. The major findings were of marked prostatomegaly (165 g) with obstruction to urine outflow resulting in dilatation and trabeculation of the bladder and bilateral hydroureteronephrosis. The bladder contained 1.5 l of yellow urine and the kidneys weighed only 109 g on the left and 125 g on the right (N = 140-160 g). Histological examination of the prostate revealed benign nodular hyperplasia. Biochemical analysis of vitreous humor demonstrated a creatinine of 1579 μmol/L (normal 45-90) and a urea of 133.4 mmol/L (normal 2.5-7.1). Despite genitourinary causes of sudden and/or unexpected death being rare in routine forensic practice, this case demonstrates significant underlying obstructive renal disease that resulted in sudden death and that had remained undiagnosed until the time of autopsy.
一名 66 岁男子被发现在家中死亡。他有营养不良的病史，最近有呕吐发作。尸检时，死者消瘦，体重指数（BMI）为 16.1。主要发现为明显的前列腺肥大（165 克），导致尿液流出受阻，导致膀胱扩张和小梁化以及双侧肾盂积水。膀胱中含有 1.5 升黄色尿液，左肾重 109 克，右肾重 125 克（N=140-160 克）。前列腺的组织学检查显示良性结节性增生。玻璃体化学分析显示肌酐为 1579 μmol/L（正常 45-90），尿素为 133.4 mmol/L（正常 2.5-7.1）。尽管泌尿生殖系统原因导致的突发性和/或意外死亡在常规法医实践中很少见，但本例表明存在严重的潜在阻塞性肾病，导致突然死亡，并且在尸检时仍未确诊。
