Journal Article

An atypical case of fatal ‘esophageal apoplexy’: post-mortem findings and differential diagnosis

O’Donnell, Chris, de Boer, Hans H.

2024

Overview

Forensic pathologists need to have comprehensive knowledge of a large variety of causes of sudden natural death. We describe a case of sudden and unexpected death in woman in her sixties due to rupture of a large paraesophageal hematoma. The post-mortem examination and differential diagnosis are discussed. The combined findings of whole-body post-mortem CT imaging (PMCT), targeted PMCT angiography, autopsy, and histology are most in keeping with ‘esophageal apoplexy’; a rare cause of hemorrhage in the esophageal wall. A review of the literature indicates that most cases of esophageal apoplexy are self-limiting and that fatal complications are exceedingly rare. Our case demonstrates that esophageal apoplexy can present as sudden unexpected death.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: Angiography / Autopsies / Autopsy / Case Report / Computed tomography / Death & dying / Death, Sudden - etiology / Diagnosis / Diagnosis, Differential / Diagnostic tests / Esophageal Diseases - diagnostic imaging / Esophageal Diseases - pathology / Esophagus / Esophagus - diagnostic imaging / Esophagus - pathology / Female / Forensic Medicine / Forensic pathology / Hematoma / Hematoma - diagnostic imaging / Hematoma - pathology / Hemorrhage / Histology / Humans / Literature reviews / Medical diagnosis / Medical Law / Medicine / Medicine & Public Health / Middle Aged / Rupture, Spontaneous / Sudden death / Tomography, X-Ray Computed