Skip to main content
Erschienen in:

01.04.2020 | Images in Forensics

Lethal mesenteric perforation by osteophytes after blunt abdominal trauma

verfasst von: Arnaud Le Gallo, Christophe Loire, Maisy Lossois, Pierre-Antoine Peyron

Erschienen in: Forensic Science, Medicine and Pathology | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

A 50 year-old homeless man was found dead the day after he had sustained blunt abdominal trauma during a physical assault. Autopsy revealed no apparent injury to the abdominal wall, but showed a massive hemoperitoneum resulting from a large (8 cm) tear of the mesenteric root. It also revealed prominent and diffuse spinal osteophytes predominating in the lumbar region, where they were fused and formed a large anterior ossified excrescence. The diagnosis of diffuse idiopathic skeletal hyperostosis was established in the presence of continuous ossification along the anterior aspect of five contiguous vertebral bodies, without any additional features of degenerative disease on imaging. Death was attributed to intra-abdominal hemorrhage due to mesenteric perforation caused by blunt abdominal trauma in the context of diffuse idiopathic skeletal hyperostosis. This pre-existing condition was considered an aggravating factor, as anterior lumbar osteophytosis had made the mesentery more vulnerable to blunt trauma by reducing both the space separating the abdominal wall from the spine and the surface of interaction between the spine and the mesentery. Only a few cases of osteophyte-related visceral injury have been described in the literature. To our knowledge, this is the first reported case of lethal abdominal injury caused by osteophytes after blunt trauma.
Literatur
1.
Zurück zum Zitat Kordzadeh A, Melchionda V, Rhodes KM, Fletcher EO, Panayiotopolous YP. Blunt abdominal trauma and mesenteric avulsion: a systematic review. Eur J Trauma Emerg Surg. 2016;42:311–5.CrossRef Kordzadeh A, Melchionda V, Rhodes KM, Fletcher EO, Panayiotopolous YP. Blunt abdominal trauma and mesenteric avulsion: a systematic review. Eur J Trauma Emerg Surg. 2016;42:311–5.CrossRef
2.
Zurück zum Zitat Mehta N, Babu S, Venugopal K. An experience with blunt abdominal trauma: evaluation, management and outcome. Clin Pract. 2014;4:599.CrossRef Mehta N, Babu S, Venugopal K. An experience with blunt abdominal trauma: evaluation, management and outcome. Clin Pract. 2014;4:599.CrossRef
3.
Zurück zum Zitat Bège T, Brunet C, Berdah SV. Hollow viscus injury due to blunt trauma: a review. J Visc Surg. 2016;153:61–8.CrossRef Bège T, Brunet C, Berdah SV. Hollow viscus injury due to blunt trauma: a review. J Visc Surg. 2016;153:61–8.CrossRef
4.
Zurück zum Zitat Bège T, Ménard J, Tremblay J, Denis R, Arnoux PJ, Petit Y. Biomechanical analysis of traumatic mesenteric avulsion. Med Biol Eng Comput. 2015;53:187–94.CrossRef Bège T, Ménard J, Tremblay J, Denis R, Arnoux PJ, Petit Y. Biomechanical analysis of traumatic mesenteric avulsion. Med Biol Eng Comput. 2015;53:187–94.CrossRef
5.
Zurück zum Zitat Byard RW. How reliable is external examination in identifying internal injuries - Casper’s sign revisited. J Forensic Legal Med. 2012;19:419–21.CrossRef Byard RW. How reliable is external examination in identifying internal injuries - Casper’s sign revisited. J Forensic Legal Med. 2012;19:419–21.CrossRef
6.
Zurück zum Zitat Velmahos GC, Tatevossian R, Demetriades D. The “seat belt mark” sign: a call for increased vigilance among physicians treating victims of motor vehicle accidents. Am Surg. 1999;65:181–5.PubMed Velmahos GC, Tatevossian R, Demetriades D. The “seat belt mark” sign: a call for increased vigilance among physicians treating victims of motor vehicle accidents. Am Surg. 1999;65:181–5.PubMed
7.
Zurück zum Zitat Utsinger PD. Diffuse idiopathic skeletal hyperostosis. Clin Rheum Dis. 1985;11:325–51.PubMed Utsinger PD. Diffuse idiopathic skeletal hyperostosis. Clin Rheum Dis. 1985;11:325–51.PubMed
8.
Zurück zum Zitat Resnick D, Shapiro RF, Wiesner KB, Niwayama G, Utsinger PD, Shaul SR. Diffuse idiopathic skeletal hyperostosis (DISH) [ankylosing hyperostosis of Forestier and Rotes-Querol]. Semin Arthritis Rheum. 1978;7:153–87.CrossRef Resnick D, Shapiro RF, Wiesner KB, Niwayama G, Utsinger PD, Shaul SR. Diffuse idiopathic skeletal hyperostosis (DISH) [ankylosing hyperostosis of Forestier and Rotes-Querol]. Semin Arthritis Rheum. 1978;7:153–87.CrossRef
9.
Zurück zum Zitat Resnick D, Niwayama G. Entheses and enthesopathy. Anatomical, pathological, and radiological correlation. Radiology. 1983;146:1–9.CrossRef Resnick D, Niwayama G. Entheses and enthesopathy. Anatomical, pathological, and radiological correlation. Radiology. 1983;146:1–9.CrossRef
10.
Zurück zum Zitat Troillet N, Gerster JC. Forestier disease and metabolism disorders. A prospective controlled study of 25 cases. Rev Rhum Ed Fr. 1993;60:274–9.PubMed Troillet N, Gerster JC. Forestier disease and metabolism disorders. A prospective controlled study of 25 cases. Rev Rhum Ed Fr. 1993;60:274–9.PubMed
11.
Zurück zum Zitat Sarzi-Puttini P, Atzeni F. New developments in our understanding of DISH (diffuse idiopathic skeletal hyperostosis). Curr Opin Rheumatol. 2004;16:287–92.CrossRef Sarzi-Puttini P, Atzeni F. New developments in our understanding of DISH (diffuse idiopathic skeletal hyperostosis). Curr Opin Rheumatol. 2004;16:287–92.CrossRef
12.
Zurück zum Zitat Senolt L, Hulejova H, Krystufkova O, Forejtova S, Andres Cerezo L, Gatterova J, et al. Low circulating Dickkopf-1 and its link with severity of spinal involvement in diffuse idiopathic skeletal hyperostosis. Ann Rheum Dis. 2012;71:71–4.CrossRef Senolt L, Hulejova H, Krystufkova O, Forejtova S, Andres Cerezo L, Gatterova J, et al. Low circulating Dickkopf-1 and its link with severity of spinal involvement in diffuse idiopathic skeletal hyperostosis. Ann Rheum Dis. 2012;71:71–4.CrossRef
13.
Zurück zum Zitat Harris J, Carter AR, Glick EN, Storey GO. Ankylosing hyperostosis. I. Clinical and radiological features. Ann Rheum Dis. 1974;33:210–5.CrossRef Harris J, Carter AR, Glick EN, Storey GO. Ankylosing hyperostosis. I. Clinical and radiological features. Ann Rheum Dis. 1974;33:210–5.CrossRef
14.
Zurück zum Zitat Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology. 1976;119:559–68.CrossRef Resnick D, Niwayama G. Radiographic and pathologic features of spinal involvement in diffuse idiopathic skeletal hyperostosis (DISH). Radiology. 1976;119:559–68.CrossRef
15.
Zurück zum Zitat Forestier J, Rotes-Querol J. Senile ankylosing hyperostosis of the spine. Ann Rheum Dis. 1950;9:321–30.CrossRef Forestier J, Rotes-Querol J. Senile ankylosing hyperostosis of the spine. Ann Rheum Dis. 1950;9:321–30.CrossRef
16.
Zurück zum Zitat Giammalva GR, Iacopino DG, Graziano F, Gulì C, Pino MA, Maugeri R. Clinical and radiological features of Forestier’s disease presenting with dysphagia. Surg Neurol Int. 2018;9:236.CrossRef Giammalva GR, Iacopino DG, Graziano F, Gulì C, Pino MA, Maugeri R. Clinical and radiological features of Forestier’s disease presenting with dysphagia. Surg Neurol Int. 2018;9:236.CrossRef
17.
Zurück zum Zitat Yoshimatsu Y, Tobino K, Maeda K, Kubota K, Haruta Y, Adachi H, et al. Management of airway obstruction due to diffuse idiopathic skeletal hyperostosis in the cervical spine: a case report and literature review. Intern Med. 2019;58:271–6.CrossRef Yoshimatsu Y, Tobino K, Maeda K, Kubota K, Haruta Y, Adachi H, et al. Management of airway obstruction due to diffuse idiopathic skeletal hyperostosis in the cervical spine: a case report and literature review. Intern Med. 2019;58:271–6.CrossRef
18.
Zurück zum Zitat Tzikas S, Triantafyllou K, Papadopoulos C, Vassilikos V. A case of a paracardial osteophyte causing atrial compression. Case Rep Med. 2016;2016:4325830.CrossRef Tzikas S, Triantafyllou K, Papadopoulos C, Vassilikos V. A case of a paracardial osteophyte causing atrial compression. Case Rep Med. 2016;2016:4325830.CrossRef
19.
Zurück zum Zitat Nouri A, Fehlings MG. Diffuse idiopathic skeletal hyperostosis with cervical myelopathy. CMAJ. 2017;189:E410.CrossRef Nouri A, Fehlings MG. Diffuse idiopathic skeletal hyperostosis with cervical myelopathy. CMAJ. 2017;189:E410.CrossRef
20.
Zurück zum Zitat Olsen AB, Ralhan T, Harris JH, Evani V. Superior mesenteric artery pseudoaneurysm after blunt abdominal trauma. Ann Vasc Surg. 2013;27:674–8.CrossRef Olsen AB, Ralhan T, Harris JH, Evani V. Superior mesenteric artery pseudoaneurysm after blunt abdominal trauma. Ann Vasc Surg. 2013;27:674–8.CrossRef
21.
Zurück zum Zitat Khan A, Farnan T, Hall SJ, McClure MJ. Cervical osteophyte causing perforation of the nasopharynx. Ulster Med J. 2004;73:57–8.PubMedPubMedCentral Khan A, Farnan T, Hall SJ, McClure MJ. Cervical osteophyte causing perforation of the nasopharynx. Ulster Med J. 2004;73:57–8.PubMedPubMedCentral
22.
Zurück zum Zitat Vanezis P, Tate GP. Cervical osteophytosis and laryngeal trauma. Med Sci Law. 1987;27:99–102.CrossRef Vanezis P, Tate GP. Cervical osteophytosis and laryngeal trauma. Med Sci Law. 1987;27:99–102.CrossRef
23.
Zurück zum Zitat Sauvageau A, Kremer C, Racette S. Traumatic heart perforation by a D5 osteophyte: a case report. Med Sci Law. 2007;47:350–2.CrossRef Sauvageau A, Kremer C, Racette S. Traumatic heart perforation by a D5 osteophyte: a case report. Med Sci Law. 2007;47:350–2.CrossRef
24.
Zurück zum Zitat Atcheson SG, Petersen GV, Fred HL. Ill-effects of cardiac resuscitation: report of two unusual cases. Chest. 1975;67:615–6.CrossRef Atcheson SG, Petersen GV, Fred HL. Ill-effects of cardiac resuscitation: report of two unusual cases. Chest. 1975;67:615–6.CrossRef
Metadaten
Titel
Lethal mesenteric perforation by osteophytes after blunt abdominal trauma
verfasst von
Arnaud Le Gallo
Christophe Loire
Maisy Lossois
Pierre-Antoine Peyron
Publikationsdatum
01.04.2020
Verlag
Springer US
Erschienen in
Forensic Science, Medicine and Pathology / Ausgabe 3/2020
Print ISSN: 1547-769X
Elektronische ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-020-00238-z

Neu im Fachgebiet Pathologie

Pathologie der Milz

Nach einer Beschreibung der Milzanatomie und Darstellung der diagnostisch wichtigsten immunhistochemischen Färbungen zur Identifizierung der normalen Milzkompartimente werden am Beispiel eines nordafrikanischen Patienten mit rezentem …

Molekular definierte Nierenzellkarzinome 2025

Im Zuge der Überarbeitung der WHO-Klassifikation im Jahr 2022 konnten für mehrere Nierenzellkarzinome (NZK), die sich zuvor nicht eindeutig den bis dahin definierten Tumortypen zuordnen ließen, jedoch gemeinsame morphologische und molekulare …

Wichtige Änderungen in der WHO-Klassifikation der Hodentumoren 2022

In der 5. Auflage der „WHO-Klassifikation der Tumoren der ableitenden Harnwege und des männlichen Genitaltrakts“ sind bedeutende Anpassungen an den bisherigen Klassifikationen vorgenommen worden. Diese betreffen bei den Keimzelltumoren des Hodens …

DNA mixture deconvolution using fully continuous models EuroForMix and EFMrep

  • Open Access
  • Originalien

Mixture deconvolution is a powerful tool for inferring individual DNA profiles from DNA mixtures for subsequent transmission to a database or database queries. To carry out deconvolution, a mixed trace can be interpreted either manually by an …