Variable topography of black oesophagus (acute necrotising oesophagitis).

Black oesophagus, or acute necrotising oesophagitis, is characterised by diffuse circumferential black discolouration of the distal oesophagus associated with mucosal necrosis. A consistent feature is a very sharp line of demarcation at the gastro-oesophageal junction. Two cases are reported to demonstrate differences in the lower margin.

Acute drug toxicity as a risk factor for lethal deep venous thrombosis.

Thrombosis of the deep veins of the legs is a relatively common occurrence initiated by venous stasis, endothelial damage or hypercoagulable states. Prolonged sitting has also been associated with thrombotic events. A case is reported where immobility caused by drug overdose resulted in lethal pulmonary thromboembolism.

Lethal gastrointestinal manifestations of COVID-19 infection at autopsy.

COVID-associated acute mesenteric ischaemia is a rare event that has a high mortality rate, particularly in the elderly. Despite gastrointestinal symptoms being relatively common in COVID-19 infections, however, lethal gut complications are often not considered. Two cases with fatal COVID-associated acute mesenteric ischaemia are therefore reported.

Forensic considerations in nonthrombotic pulmonary embolism: A case report and review.

Nonthrombotic pulmonary embolism is defined as the partial or total occlusion of the pulmonary circulation by various nonthrombotic agents, such as biological, nonbiological and foreign body material. A case is reported of lethal embolism of fragments of a renal calculus: A 64-year-old woman collapsed and died following laser lithotripsy. At autopsy calculous debris was found in the calyces of the right kidney with widespread microscopic fragments of birefringent foreign material in keeping with renal calculus within the pulmonary arterioles.

Fatal exulceratio simplex (dieulafoy lesion) - a case report and review.

A 64-year-old man involved in a low-speed vehicle crash was found at autopsy to have altered blood extending from his stomach to his rectum. Within the stomach a small arterial vessel opened onto the mucosa of the posterior wall of the antrum adjacent to the pylorus with no adjacent mucosal ulceration or malignancy. Histologic sections showed the typical appearances of a Dieulafoy lesion with a tortuous small arteriole within the submucosa extending to the gastric lumen with an overlying cap of recently formed clot.

Laryngeal oncocytic cystadenoma and sudden death.

An 86-year-old woman with Alzheimer disease collapsed in her nursing home and was not able to be resuscitated. At autopsy, the major findings were in the larynx where a pedunculated oncocytic cystadenoma had occluded the glottis. Oncocytic cysts or cystadenomas of the larynx are rare histologically benign lesions that account for only 0.

Patterned lividity - the 'underwear sign'.

Lividity or livor mortis occurs when blood settles in dependent areas after death due to gravitational effects. Patterned lividity may result from a body lying against a variety of surfaces. Two case are presented where lividity was prevented by tight fitting elastic underwear except in areas where letters from the manufacturers' names had elevated the material, thus permitting capillaries in the underlying skin to fill.

Lethal giant basal cell carcinoma.

Basal cell carcinomas are the most common malignancy in Caucasian populations with a very low predisposition to metastatic disease and an excellent prognosis if appropriately treated. Given the rarity of a lethal outcome two cases are reported. : A 61-year-old reclusive man who had an untreated facial basal cell carcinoma for 10 years died of hypothermia and sepsis complicating the extensively ulcerated and infected tumour.

Ludwig angina and sudden death.

A 27-year-old man presented to hospital with neck swelling and difficulty breathing following a recent tooth extraction. He underwent uncomplicated surgical drainage of the submandibular region after which he became acutely short of breath and collapsed and was not able to be resuscitated. At autopsy the major findings were swelling of the neck due to diffuse cellulitis with edema and neutrophil infiltrates within connective tissue and marked submucosal edema of the epiglottis, glottic inlet and tonsils sufficient to cause airway obstruction.

Unexpected Death Associated With Clostridial Sepsis.

An 85-year-old woman with a history of breast carcinoma presented to hospital after gradual onset of abdominal pain with hypotension, jaundice, and massive intravascular hemolysis. This was caused by Clostridium perfringens septicemia originating from a liver abscess. Clostridium perfringens septicemia is a rare infection that has a high mortality rate, given that it is frequently unable to be diagnosed until postmortem examination.

Actinomyces in Forensic Practice.

A 19-year-old woman in septic shock with recent computed tomography findings of a loculated hepatic abscess was transferred to an intensive care unit where she went into asystolic cardiac arrest. After resuscitation, surgical exploration revealed a purulent pericardial effusion with tamponade and a liver abscess. Microbiological analyses from both sites were negative.

Camel-Related Deaths-A Forensic Overview.

Camels are ungulates of the genus Camelus and have been used for centuries in parts of Asia and Africa for transport and sustenance. Handling of camels is not without its dangers, and 4 cases from South Australia are reported with a review of lethal camel-related issues. Case 1 is a 56-year-old man who died of multiple blunt force injuries after he had attempted to move a 7-year-old female dromedary (Camelus dromedarius).

Signet-ring cell appearance of atrophic fat cells.

Cells with 'signet-ring' appearance were found at post-mortem examination of a man with a history of chronic illness, weight loss and multiple regions of 'bowel thickening' during life. Due to the decedent's history, the finding raised the possibility of disseminated signet-ring adenocarcinoma. However, the vacuoles did not stain for mucin and the cells did not stain for keratin.

Delayed fatal upper-airway obstruction due to laryngopharyngeal burns and thermal epiglottis.

A 48-year-old man complained of throat swelling and difficulty swallowing after eating hot food. Several hours later, he collapsed and was observed to be gasping for breath. Bystander and ambulance-initiated cardiopulmonary resuscitation was unsuccessful, and he was pronounced deceased at the scene.

Obturator hernia and the elderly.

An 84-year-old woman with a history of weight loss, anorexia and episodic vomiting was admitted to hospital where she died soon afterwards. Her diagnosis was acute renal injury due to dehydration and malnutrition. At autopsy the body was cachectic with a small intestinal obstruction due to herniation through a defect at the anterolateral aspect of the obturator foramen.

Lethal manifestations of angioedema.

An 86-year-old woman with a history of angioedema was found dead at her home address. She had recently complained of a swollen tongue. At autopsy the tongue was grossly edematous, protruding from the mouth.

Lethal phlegmonous colitis.

A 52-year-old man died soon after admission to hospital with a severe metabolic acidosis and likely sepsis. He had a past history of alcohol abuse with withdrawal seizures. An abdominal computed tomography scan showed thickened bowel loops but no obvious ischaemic changes, and a blood culture yielded a pure growth of Escherichia coli.

Lethal fat embolism complicating Sotos syndrome.

Sotos syndrome is a rare congenital syndrome caused by deletions or mutations in the NSD1 gene (chromosome 5q35) which results in overgrowth. A wide range of manifestations may result in unexpected and/or early death, including congenital cardiac malformations and tumours, epilepsy, intra-tumoural haemorrhage or embolism and bleeding diatheses. A case of lethal pulmonary fat embolism complicating revision of a left total hip replacement following spontaneous fracture is reported in a 39-year-old man with Sotos syndrome.

Double-chambered left ventricle - a "heart within a heart".

A 20-year-old previously well man drowned after performing a back-flip off a bridge into a river. At autopsy no significant injuries or organic illness were identified. An unusual incidental finding was a double chambered left ventricle, or so-called "heart within a heart", with the left ventricle subdivided into two separate chambers by a muscular septum.