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一名被拘留者因吞食异物后多器官感染导致致命性脾破裂的病例报告。

A case report of fatal splenic rupture caused by multiple organ infection following foreign body ingestion in a detainee.

作者信息

Chen Ke, Li Yingmin, Zhang Guozhong, Zuo Min, Bi Haitao, Shi Weibo, Cong Bin

机构信息

Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Centre of Forensic Medical Molecular Identification, College of Forensic Medicine, Hebei Medical University, Shijiazhuang, China.

Department of Forensic Medicine, College of Medicine, Nantong University, Nantong, China.

出版信息

Forensic Sci Res. 2025 Feb 25;10(2):owaf008. doi: 10.1093/fsr/owaf008. eCollection 2025 Jun.

Abstract

Among forensic and clinical cases, infections caused by the ingestion of foreign bodies are common. In general, timely removal of the foreign body and appropriate treatment prevent serious consequences. We herein report a rare case of death due to massive bleeding caused by splenic rupture following foreign body ingestion. To our knowledge, no similar cases have been reported in the Chinese or international literature, making this case particularly noteworthy. In this instance, the decedent was in a detention centre for a criminal offence and swallowed a wire unnoticed. The wire remained in his stomach for >50 days, leading to a severe suppurative infection in the gastric tissue. This resulted in suppurative inflammation affecting multiple organs, including the liver, pancreas, and spleen. The condition ultimately led to the rupture of splenic vessels and the formation of a rare, massive haematoma beneath the splenic capsule. Based on medical records and histopathological findings, we infer that the wire had remained in the stomach for ~50 days, triggering severe suppurative infections in multiple organs. The spleen eventually ruptured, and the victim died of massive haemorrhage.

摘要

在法医和临床案例中,因吞食异物导致的感染很常见。一般来说,及时取出异物并进行适当治疗可避免严重后果。我们在此报告一例罕见的因吞食异物后脾破裂导致大出血死亡的病例。据我们所知,中国和国际文献中均未报道过类似病例,因此该病例尤为值得关注。在此案例中,死者因刑事犯罪被关押在拘留中心,无意间吞食了一根铁丝。铁丝在其胃内留存超过50天,导致胃组织严重化脓性感染。这引发了包括肝脏、胰腺和脾脏在内的多个器官的化脓性炎症。病情最终导致脾血管破裂,在脾包膜下形成罕见的巨大血肿。根据病历和组织病理学检查结果,我们推断铁丝在胃内留存约50天,引发了多个器官的严重化脓性感染。脾脏最终破裂,受害者死于大出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c9/12007405/00f621931328/owaf008f1.jpg

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