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Fatal intussusception in infancy: an experience in forensic autopsy
Paul M Ng'walali1, Kosei Yonemitsu, Shigeyuki Tsunenari
1Department of Forensic Medicine, Kumamoto University School of Medicine, 2-2-1 Honjyo, Kumamoto 860-0811, Japan. ngwalali@medic.kumamoto-u.ac.jp
Insights
A rare fatal case of intussusception in an infant highlights the importance of forensic autopsy. This condition, usually treatable, can present without typical symptoms, leading to unexpected infant death.
Area of Science:
- Forensic Pathology
- Pediatric Surgery
Background:
- Intussusception is a common pediatric surgical emergency but rarely fatal.
- Recent decades have seen declining morbidity and mortality rates for this condition.
Observation:
- A 7-month-old infant was found unresponsive and pronounced dead.
- Forensic autopsy revealed intussusceptions at two ileal sites.
- The infant exhibited 'painless intussusception' with no prior signs of distress.
Findings:
- The autopsy identified dual intussusceptions as the cause of death.
- The case represents an uncommon fatal outcome for intussusception.
Implications:
- Highlights the potential for avoidable deaths from intussusception.
- Underscores the critical role of forensic autopsy in unexplained infant deaths.
- Emphasizes the significance of recognizing 'painless intussusception' in clinical practice.
Abstract:
Intussusception, although a common cause of pediatric surgical emergencies, is a rarely fatal condition. A 7-month-old infant who was discovered in her cot was unresponsive and pronounced dead after 2 h of uneventful cardiopulmonary resuscitation in an emergency hospital. Forensic autopsy which was performed in order to clarify the circumstances surrounding the death revealed intussusceptions at two sites of the ileum. Although morbidity and mortality rates from the condition have progressively declined in recent decades but avoidable deaths still occur as was experienced in the present case. The forensic pathology significance in this case was the occurrence of 'painless intussusception' whereby the affected child clinically exhibited no discomfort or characteristic features of acute abdomen until death. In summary, the present case has exhibited an uncommon fatal occurrence and demonstrated the importance of forensic autopsy in such unexpected sudden infant deaths.
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