External bleeding from femoro-crural vein bypass with aneurysmal dilation

Area of Science:

• Forensic pathology
• Vascular surgery
• Medical case reports

Background:

• External bleeding deaths are often presumed violent, but natural causes exist.
• Fatal bleeding from skin defects is rare and raises suspicion of trauma.
• Autopsies are crucial for determining the source and cause of fatal bleeding.

Observation:

• A man in his early 60s died from external bleeding.
• The bleeding resulted from a ruptured femoro-crural bypass graft.
• The bypass was implanted 8 years prior for peripheral arterial occlusive disease (PAD) with gangrene.

Findings:

• The rupture originated from a rare true aneurysm of an autologous vein bypass.
• The aneurysm rupture penetrated subcutaneous and skin layers.
• This led to exsanguination and death.

Implications:

• This case underscores the importance of considering non-traumatic causes for external bleeding deaths.
• Rarer vascular complications, like bypass aneurysms, can be fatal.
• Accurate diagnosis requires thorough post-mortem examination, especially in suspicious cases.