主动脉夹层破裂致死63例法医病理学分析

目的探讨主动脉夹层破裂的死亡原因、临床表现及法医病理学特点。方法对中山大学法医鉴定中心2001—2011年受理的63例主动脉夹层破裂致死的案例进行回顾性分析。结果主动脉夹层破裂好发于中青年男性(30～49岁);病理分型以DeBakeyⅡ型为主;常见死亡原因为心脏压塞;临床症状以中腹痛最为常见,但其疼痛部位和主动脉夹层部位吻合度不高,部分可无明显症状;破裂口多在升主动脉,多伴有动脉粥样硬化、高血压病理改变。结论熟悉主动脉夹层的临床表现及法医病理学特点,对此种疾病生前诊断及死因鉴定具有重要指导意义。     

主动脉夹层动脉瘤破裂致死亡1例

1　案例资料临床资料　死者 ,男 ,4 1岁 ,某镇村民。 2 0 0 3年6月 7日上午 9时 ,因“前胸部突然疼痛、胸闷已缓解”到乡卫生院诊治 ,当日下午 4时左右经抢救无效死亡。医院诊断 :高血压 ,冠心病 ,心肌梗塞。尸体检验　尸长 170cm ,体态微胖 ,四肢无异常 ,左眉弓处见一长约 1.5     

主动脉夹层动脉瘤破裂4例尸检报告

夹层动脉瘤是由于动脉壁受血流切力的作用而发生内膜撕裂，血液进入病理性疏松的中膜，并顺血流将其撕开，从而形成的一个假血管腔。主动脉夹层动脉瘤破裂引起的猝死常需进行法医学死因鉴定。笔者在实践工作中遇到4例，现报道如下。     

主动脉夹层破裂致死法医学鉴定1例

正1案例资料1.1简要案情及临床经过苟某,男,54岁。某年9月29日11时15分许,苟某与人吵架后因四肢无力、浑身出汗、胸闷想吐之主诉到当地一私人医生处求治,被给予静脉输液治疗,30min后出现意识不清,急送当地医院。同日16时5分该医院急诊病历摘要:意识丧失,无呼吸心跳,双侧瞳孔散大固定,口唇发绀,面部及肢体末梢苍白,给予胸外按压、呼吸机辅助呼吸等抢救无效死亡。据     

巨大腹主动脉夹层破裂死亡1例

主动脉夹层破裂死亡的案例已有不少报道 ,但腹主动脉的巨大动脉夹层破裂死亡的案例少见 ,笔者遇 1例 ,现报道如下。1　案　例张某 ,女 ,5 5岁。某日中午在田间劳动时觉左腹部疼痛 ,到卫生所治疗 ,肌肉注射山莨菪硷(6 5 42 )一支后病情缓解回家。下午 5时因腹部疼痛加剧 ,再次到     

胸主动脉夹层动脉瘤破裂猝死1例

1案例资料 曹某,男,56岁,农民工,高血压病史2年。2007年1月28日,在工作时墙体突然倒塌,其左侧胸部受到砸压,当时因无明显不适,未去医院就诊。2月4日,猝死于家中。     

主动脉夹层破裂致死20例分析

目的 分析主动脉夹层破裂致死的相关特征,以期为主动脉夹层破裂致死案例的法医学鉴定提供参考.方法 收集主动脉夹层破裂致死的法医学鉴定案例20例,对死者年龄、性别、临床症状、死亡原因、病理特征、易患危险因素(高血压、冠心病等)、伤病关系等进行统计分析.结果(1)20例中涉及医疗纠纷有10例,涉及外伤有7例;1例首发症状为典...     

非高血压主动脉夹层破裂猝死8例法医病理学分析

目的探讨非高血压主动脉夹层猝死的死因、临床症状及法医病理形态学特点,以期为非高血压主动脉夹层猝死的法医病理学诊断及规范尸体检验提供参考。方法对2007-2015年本司法鉴定中心受理鉴定的8例非高血压主动脉夹层猝死的案例进行统计、归纳和分析。结果非高血压主动脉夹层破裂多见于40岁以下男性,病理分型主要为De Bakey I型,临床表现多不典型,无1例临床确诊。经基因检测1例确诊为Marfan综合征,1例存在Smad3基因变异。非高血压主动脉夹层均无高血压病史,排除外伤,均未见高血压病相关病理学改变,镜下大动脉检见弹力纤维减少、平滑肌减少、囊性中膜变性、炎细胞浸润等改变,某些案例还见于中动脉。结论非高血压主动脉夹层发病机制复杂,与遗传学和炎症等多因素密切相关,常常波及全身多血管病变的特点。尸检时除了系统检验大血管的同时,还有必要对全身的中动脉进行检验,建议积极进行基因检测,探究发病机制。     

交通事故胸部外伤促发主动脉夹层破裂1例

1 案例1．1简要案情吴某，女，84岁，某年4月13日上午被发现死于某国道旁的水沟中。后经公安机关调查证实，4月12日晚，吴某在国道上步行时，一肇事者骑摩托车撞倒吴某并致其当场死亡，遂将其抛弃于附近的水沟中。     

拔罐后主动脉夹层破裂死亡1例

<正>1案例1.1简要案情及病史摘要冯某,男,43岁,某年12月2日20:10左右,因“背心胀痛、胃胀痛”于院外某中医理疗康复中心行真空拔罐治疗（约10 min）,期间无不适,取罐后自觉上述症状缓解,遂由家人陪护于当日21:00返家。拔罐6 h后因“腹痛待查”于次日02:10入住某人民医院。     

Traumatic rupture of an abdominal aortic aneurysm associated with the use of a seatbelt

Injury to the abdominal aorta after blunt trauma continues to be a relatively infrequent occurrence. In this report, we describe a case of traumatic rupture of an abdominal aortic aneurysm associated with inappropriate seatbelt use.     

Fatal traumatic rupture of an aortic aneurysm of the sinus of Valsalva: an autopsy case

This report describes an autopsy case of a rare type of aortic sinus of Valsalva aneurysm, which caused fatal rupture from a blunt chest impact. A 51-year-old male was hit in the chest with a fist, lost consciousness after about 15min and died after approximately 7h. The postmortem examination revealed a large saccular aneurysm of the right coronary sinus bulging on the right atrium, which had a full laceration causing pericardial hematoma (cardiac tamponade). A related chest wall injury was observed in the right outer mammary region. A rare type of bulging onto the right atrium and subsequent sclerosis of the right coronary artery appeared to have greatly contributed to the fatal rupture.     

Sudden death caused by tension pneumothorax after rupture of a thoracic aortic aneurysm. Case report

A rare case of fatal tension pneumothorax is reported. An aged Japanese man with marked subcutaneous emphysema of the neck was found collapsed in a betting office. He was ascertained to have left tension pneumothorax, based on radiographic examinations carried out before his death. At autopsy, severe pneumomediastinum was observed, and the descending thoracic aorta with a ruptured dissecting aneurysm was closely adhered to the left lung pleura. The hemorrhage spread into the pulmonary parenchyma and finally spouted out from the surface of the lung apex. Because the blood loss itself was not fatal in quantity, it is concluded that the patient died of tension pneumothorax caused by a lung penetration from the rupture of an aortic aneurysm.     

Fatal dissecting aneurysm of the internal carotid artery with delayed symptoms following facial impact.

A fatal dissecting aneurysm of the internal carotid artery occurred in a 16-year-old male following facial impact in an automobile accident. The patient showed no neurologic deficit until two days after the automobile accident, when he suddenly started having seizures and developed right-sided hemiparesis. There was no evidence of direct trauma to the neck externally or internally. The only injuries observed in the head and face were two skin lacerations in the chin area. His condition rapidly deteriorated, and he expired on the fourth hospital day. The gross and microscopic findings for the internal carotid artery are presented. The possible mechanisms for the vascular lesion and a review of the literature are discussed.     

产后孤立性髂动脉瘤破裂致死1例

孤立性髂动脉瘤指仅发生于髂动脉的瘤样扩张性病变,单发或多发性,亦可双侧均受累,以管径大于2.5cm为诊断标准,其破裂率可高达75%,临床上较少见,并与死亡密切相关。[1]发生于年轻女性剖宫产后的孤立性髂动脉瘤破裂致死者尤为罕见,尚未见有报道,笔者在检案中遇到1例,现报告如下。案例资料某女,27岁,职员。孕1产0,末次月经1999年9月18日,平时月经规律,预产期2000年6月25日,孕期常规产检未发现明显异常。2000年6月9日出现阴道流水,无腹痛及阴道出血,以“孕37+4周待产,胎膜早破”收入院。于当日下午6点30分行剖宫产术,以LO P顺利助娩一女活婴,1…     

产后孤立性髂动脉瘤破裂致死1例

孤立性髂动脉瘤指仅发生于髂动脉的瘤样扩张性病变，单发或多发性，亦可双侧均受累。     

创伤的AIS评分与损伤程度评定的对比分析

目的 探讨损伤程度评定的分级方法。方法 收集546例损伤程度评定的案例资料,给予AIS评分,然后比较损伤程度评定和AIS评分结果。结果 两组一致性比较,经x2检验,P<0.001;两组相关性比较,经Spear-man等级相关检验,rs’=0.940,P<0.001,均有高度显著性。结论 两组比较结果,反映损伤程度变化与.AIS分级变化有密切关系,“轻伤”、“重伤”可参照AIS严重度进行分级、编码。     

Sudden and unexpected death resulting from splenic artery aneurysm rupture: two case reports of pregnancy-related fatal rupture of splenic artery aneurysm

Rupture of a splenic artery aneurysm is a rare and usually catastrophic event, most commonly associated with pregnancy. In spite of increasingly common reliance on abdominal angiography, magnetic resonance imaging, and computerized tomography during the past quarter century, clinicians uncommonly recognize any of the various splanchnic arterial aneurysms absent premonitory signs or symptoms. Accordingly, rupture of a visceral aneurysm, including splenic artery aneurysm, typically presents as sudden, unexpected obtundation or death. As a consequence, the initial recognition and diagnosis of splenic artery aneurysm rupture take place only at autopsy. This report presents two such cases of sudden death resulting from splenic artery aneurysm in a pregnant woman and a postpartum woman, respectively.