Matsumoto H, Yamamoto K, Abiru H, Yamamoto Y, Hayase T, Ojima K, Matsubayashi K, Fukui Y
Department of Legal Medicine, Kyoto University Faculty of Medicine, Japan.
Nihon Hoigaku Zasshi. 1994 Oct;48(5):343-8.
We report a case of sudden death in a 19-year-old adolescent male who had been receiving hospital treatment because of a persistent right calf pain which had started about 18 days previously. The pain had not been relieved by analgesics, and had extended to the right thigh. The post-mortem examination revealed that the cause of death was pulmonary embolism by thrombi which had arisen in the right calf veins. The bilateral pulmonary arteries were packed with thrombi, and many pulmonary branches were occluded with fresh thrombi. The right calf veins contained thrombi of differing ages. In old thrombi, massive collagen formation and hemosiderin granules were present but elastic fibers had not yet formed. Therefore, it was considered that the old thrombi had formed at the time of the patient's first visit to the hospital. The right calf pain for which the deceased had sought medical advice was considered to have been caused by the vein thrombosis. Although various risk factors for the formation of thrombi are known, in the present case no precedent causes other than obesity were identified.
我们报告一例19岁青少年男性猝死病例，该患者因持续约18天的右小腿疼痛而接受住院治疗。疼痛未因镇痛药缓解，并已蔓延至右大腿。尸检显示，死亡原因是右小腿静脉形成的血栓导致的肺栓塞。双侧肺动脉充满血栓，许多肺分支被新鲜血栓阻塞。右小腿静脉含有不同时期的血栓。在陈旧血栓中，有大量胶原形成和含铁血黄素颗粒，但尚未形成弹性纤维。因此，认为陈旧血栓在患者首次就诊时就已形成。死者就医的右小腿疼痛被认为是由静脉血栓形成所致。虽然已知多种血栓形成的危险因素，但在本病例中，除肥胖外未发现其他先前存在的病因。
