Department of Legal Medicine, International University of Health and Welfare, Japan.
Department of Pathology, International University of Health and Welfare, Japan.
Leg Med (Tokyo). 2021 Nov;53:101966. doi: 10.1016/j.legalmed.2021.101966. Epub 2021 Sep 15.
We report findings from an autopsy case who died from massive bleeding because of splenic peliosis. The case subject was an 80-year-old man who had diabetes mellitus and who was receiving hemodialysis and anticoagulant therapy. Postmortem computed tomography demonstrated massive intra-abdominal hemorrhage especially seen around the spleen. At autopsy, we found abundant hemorrhagic ascites, including a large number of clots, in the abdominal cavity. The spleen had several distinct dark red areas ranging in size from 1.5 to 2.5 cm and showed spontaneous rupture along with hematoma formation on the outside of the splenic capsule on the anterior side. From these findings, we concluded that the cause of death in this case was massive hemorrhage owing to spontaneous rupture of splenic peliosis. Although peliosis itself rarely causes death, but when it is destroyed, massive bleeding leads to death. Thus, it is necessary to know the histopathological characteristics of peliosis, in forensics.
我们报告了一例因脾海绵状瘤破裂导致大出血而死亡的尸检病例。该病例为 80 岁男性，患有糖尿病，正在接受血液透析和抗凝治疗。死后计算机断层扫描显示大量腹腔内出血，特别是脾脏周围。尸检时，我们发现腹腔内有大量血性腹水，包括大量血栓。脾脏有几个大小为 1.5 至 2.5 厘米的明显暗红色区域，并在前侧脾包膜外显示自发性破裂伴血肿形成。根据这些发现，我们得出结论，本例的死亡原因是脾海绵状瘤破裂导致的大出血。尽管海绵状瘤本身很少导致死亡，但当它被破坏时，大量出血会导致死亡。因此，在法医学中，有必要了解海绵状瘤的组织病理学特征。
