Necrotizing arteritis causing fatal massive intraperitoneal hemorrhage from a pancreatic pseudocyst. 1994

Y Ito, and A Tanegashima, and K Nishi, and Y Sukegawa, and H Kimura
Department of Legal Medicine, Kurume University School of Medicine, Japan.

We report the histopathological findings from a medicolegal autopsy case caused by sudden massive hemorrhage from a necrotic pancreatic cyst into the abdominal cavity. The histological examination revealed that the wall of the cyst was filled with hematoma and consisted of granuloma at a relative early stage, involving marginating lymphocytes, foamy lipophages, cholesterin crystals, foreign body giant cells with neutrophiles, mast cells and fibrous tissues. Since there was no epithelial lining, the lesion was diagnosed as a pseudocyst. In the wall of this pseudocyst, small arteries showed acute intense necrotizing inflammatory reactions in association with fresh thrombi. Trace of elastic fibers remained in the wall of the arteries. Since the small veins in the wall showed varix-like changes without necrosis or inflammation, it is proposed that the lethal bleeding was caused by rupture of the small arteries that exhibited severe arteritis.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010192 Pancreatic Pseudocyst Cyst-like space not lined by EPITHELIUM and contained within the PANCREAS. Pancreatic pseudocysts account for most of the cystic collections in the pancreas and are often associated with chronic PANCREATITIS. Pancreatic Pseudocysts,Pseudocyst, Pancreatic,Pseudocysts, Pancreatic
D010195 Pancreatitis INFLAMMATION of the PANCREAS. Pancreatitis is classified as acute unless there are computed tomographic or endoscopic retrograde cholangiopancreatographic findings of CHRONIC PANCREATITIS (International Symposium on Acute Pancreatitis, Atlanta, 1992). The two most common forms of acute pancreatitis are ALCOHOLIC PANCREATITIS and gallstone pancreatitis. Acute Edematous Pancreatitis,Acute Pancreatitis,Pancreatic Parenchyma with Edema,Pancreatic Parenchymal Edema,Pancreatitis, Acute,Pancreatitis, Acute Edematous,Peripancreatic Fat Necrosis,Acute Edematous Pancreatitides,Acute Pancreatitides,Edema, Pancreatic Parenchymal,Edematous Pancreatitides, Acute,Edematous Pancreatitis, Acute,Fat Necrosis, Peripancreatic,Necrosis, Peripancreatic Fat,Pancreatic Parenchymal Edemas,Pancreatitides, Acute,Pancreatitides, Acute Edematous,Parenchymal Edema, Pancreatic,Peripancreatic Fat Necroses
D010488 Polyarteritis Nodosa A form of necrotizing non-granulomatous inflammation occurring primarily in medium-sized ARTERIES, often with microaneurysms. It is characterized by muscle, joint, and abdominal pain resulting from arterial infarction and scarring in affected organs. Polyarteritis nodosa with lung involvement is called CHURG-STRAUSS SYNDROME. Essential Polyarteritis,Necrotizing Arteritis,Periarteritis Nodosa,Arteritides, Necrotizing,Arteritis, Necrotizing,Essential Polyarteritides,Necrotizing Arteritides,Polyarteritides, Essential,Polyarteritis, Essential
D010532 Peritoneal Diseases Pathological processes involving the PERITONEUM. Peritoneal Disease
D002423 Cause of Death Factors which produce cessation of all vital bodily functions. They can be analyzed from an epidemiologic viewpoint. Causes of Death,Death Cause,Death Causes
D002908 Chronic Disease Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2). Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic
D003645 Death, Sudden The abrupt cessation of all vital bodily functions, manifested by the permanent loss of total cerebral, respiratory, and cardiovascular functions. Sudden Death
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis

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