1
|
Bennett T, Martin LJ, Heathfield LJ. Global trends in the extent of death scene investigation performed for sudden and unexpected death of infant (SUDI) cases: A systematic review. Forensic Sci Int 2019; 301:435-444. [PMID: 31229847 DOI: 10.1016/j.forsciint.2019.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/25/2019] [Accepted: 06/09/2019] [Indexed: 11/28/2022]
Abstract
Sudden unexpected death of infants (SUDI) is the rapid and unexpected death of an infant aged less than 1year old. These deaths are referred for a medico-legal investigation to establish cause of death. National and regional protocols for the investigation of SUDI cases have been established in some countries and these typically include a death scene investigation component. However, there is a paucity of literature detailing the nature and extent of death scene investigation protocols. A systematic review was conducted to review the scope of death scene investigation of SUDI cases worldwide. Relevant articles (n=74) were identified by searching four literature databases, three discipline-specific journals, as well as each article's reference list, until saturation was reached. Of the 16 countries represented by the included articles, seven made specific reference to the standardised protocol used, which included photography, interviews and/or scene re-enactments. The remaining 54 studies appeared to include a subset of these analyses during death scene investigation, which varied between countries, and between SUDI admissions. This may be attributed to the differing socio-economic standings of countries, and the resources available. Only four studies were from developing countries, three of which originated from South Africa. Overall, where a standardised death scene investigation was performed, it added value to the post-mortem investigation; as such, death scene investigation should be encouraged in SUDI investigation. To this end, protocols should be established nationally, and contain core analyses, which could be expanded depending on the needs and resources of the country.
Collapse
Affiliation(s)
- Tracy Bennett
- Division of Forensic Medicine and Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa.
| | - Lorna J Martin
- Division of Forensic Medicine and Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa.
| | - Laura J Heathfield
- Division of Forensic Medicine and Toxicology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925, South Africa.
| |
Collapse
|
2
|
Tuchtan L, Delteil C, Levrat F, Bacquet J, Garcia P, Fayol L, Gorincour G, Zandotti C, Girard N, Drancourt M, Léonetti G, Piercecchi Marti MD, Bartoli C. Sudden unexpected infant death characteristics in the French region of West Provence-Alpes-Côte d'Azur. Paediatr Int Child Health 2019; 39:104-110. [PMID: 30382004 DOI: 10.1080/20469047.2018.1533734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Although the incidence of sudden unexpected infant death (SUID) has decreased since the 'Back to Sleep' campaign in English-speaking countries and other preventive campaigns, the circumstances of such deaths remain unclear. Aim: To analyse infant deaths recorded at the referral centre for sudden infant death of the West Provence-Alpes-Côte d'Azur region of France (West PACA) and the forensic medicine department of Marseille University Hospital. Methods: Information on all SUID cases from 2000 to 2017 was extracted from the referral centre for sudden infant deaths in West PACA and the forensic medicine department of Marseille. Results: The study included 130 infants over the 17 years with a very similar distribution. There was a marked male preponderance, with 61.6% of boys whatever the age at death (sex ratio 1.6). Half of the deaths occurred in the first 6 months of life and the majority (61%) of infants died during autumn and winter. Nearly one-third (33.2%) had presented with minor infections and 21% had been seen by a doctor or had been admitted to hospital. Most deaths (86.4%) occurred during sleep (night or day). Nearly half of the infants (47.7%) were discovered in a prone position. A large majority of parents (90.7%) agreed to a post-mortem examination. Only 6.2% of deaths led to legal proceedings. Nearly 16.9% remained unexplained after compiling all the data included in the protocol and 9.2% remained unexplained because of incomplete investigation, including refusal of post-mortem examination. Abuse was involved in 2.3% of cases. Conclusions: Asymptomatic infectious conditions were associated with a high proportion of SUID cases. Non-supine sleep positions were still practised. There is a need to increase SUID prevention campaigns. Abbreviations: HAS, Haute Autorité de Santé: French National Health Authority; NICHD, National Institute of Child Health and Human Development; PACA, Provence-Alpes-Côte d'Azur region of France; SUID, sudden unexpected infant death; SIDS, sudden infant death syndrome; CépiDc, Centre d'Epidémiologie sur les Causes Médicales de Décès/Center for Epidemiology on the Medical Causes of Death.
Collapse
Affiliation(s)
- Lucile Tuchtan
- a Forensic Department , APHM, Hôpital de la Timone , Marseille , France.,b CNRS, EFS, ADES , Aix Marseille Université , Marseille , France
| | - Clémence Delteil
- a Forensic Department , APHM, Hôpital de la Timone , Marseille , France.,b CNRS, EFS, ADES , Aix Marseille Université , Marseille , France
| | - Flore Levrat
- a Forensic Department , APHM, Hôpital de la Timone , Marseille , France
| | - Juliette Bacquet
- a Forensic Department , APHM, Hôpital de la Timone , Marseille , France.,b CNRS, EFS, ADES , Aix Marseille Université , Marseille , France
| | - Patricia Garcia
- c Service de Néonatologie , APHM, Hôpital de la Conception , Marseille , France
| | - Laurence Fayol
- c Service de Néonatologie , APHM, Hôpital de la Conception , Marseille , France
| | - Guillaume Gorincour
- d Département d'Imagerie Médicale , APHM, Hôpital de la Timone , Marseille , France
| | - Christine Zandotti
- e Département de Microbiologie , APHM, Hôpital de la Timone , Marseille , France
| | - Nadine Girard
- d Département d'Imagerie Médicale , APHM, Hôpital de la Timone , Marseille , France
| | - Michel Drancourt
- e Département de Microbiologie , APHM, Hôpital de la Timone , Marseille , France
| | - Georges Léonetti
- a Forensic Department , APHM, Hôpital de la Timone , Marseille , France.,b CNRS, EFS, ADES , Aix Marseille Université , Marseille , France
| | - Marie Dominique Piercecchi Marti
- a Forensic Department , APHM, Hôpital de la Timone , Marseille , France.,b CNRS, EFS, ADES , Aix Marseille Université , Marseille , France
| | - Christophe Bartoli
- a Forensic Department , APHM, Hôpital de la Timone , Marseille , France.,b CNRS, EFS, ADES , Aix Marseille Université , Marseille , France
| |
Collapse
|
3
|
Dempers JJ, Coldrey J, Burger EH, Thompson V, Wadee SA, Odendaal HJ, Sens MA, Randall BB, Folkerth RD, Kinney HC. The Institution of a Standardized Investigation Protocol for Sudden Infant Death in the Eastern Metropole, Cape Town, South Africa ,. J Forensic Sci 2016; 61:1508-1514. [PMID: 27677096 DOI: 10.1111/1556-4029.13204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/30/2015] [Accepted: 01/04/2016] [Indexed: 11/27/2022]
Abstract
The rate for the sudden infant death syndrome (SIDS) in Cape Town, South Africa, is estimated to be among the highest in the world (3.41/1000 live births). In several of these areas, including those of extreme poverty, only sporadic, nonstandardized infant autopsy, and death scene investigation (DSI) occurred. In this report, we detail a feasibility project comprising 18 autopsied infants with sudden and unexpected death whose causes of death were adjudicated according to the 1991 NICHD definitions (SIDS, n = 7; known cause of death, n = 7; and unclassified, n = 4). We instituted a standardized autopsy and infant DSI through a collaborative effort of local forensic pathology officers and clinical providers. The high standard of forensic investigation met international standards, identified preventable disease, and allowed for incorporation of research. We conclude that an effective infant autopsy and DSI protocol can be established in areas with both high sudden unexpected infant death, and elsewhere. (SUID)/SIDS risk and infrastructure challenges.
Collapse
Affiliation(s)
- Johan J Dempers
- Division of Forensic Medicine and Pathology, Department of Pathology and Western Cape Forensic Pathology Health Services, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Jean Coldrey
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Elsie H Burger
- Division of Forensic Medicine and Pathology, Department of Pathology and Western Cape Forensic Pathology Health Services, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Vonita Thompson
- Western Cape Forensic Pathology Service, Cape Town, South Africa
| | - Shabbir A Wadee
- Division of Forensic Medicine and Pathology, Department of Pathology and Western Cape Forensic Pathology Health Services, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Hein J Odendaal
- Department of Obstetrics and Gynecology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Mary Ann Sens
- Department of Pathology, University of North Dakota, Grand Forks, ND
| | - Brad B Randall
- Department of Pathology, Sanford University of South Dakota School of Medicine, Sioux Falls, SD
| | - Rebecca D Folkerth
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Hannah C Kinney
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | | |
Collapse
|
4
|
Improving sudden unexplained infant death investigation practices: an evaluation of the Centers for Disease Control and Prevention's SUID Investigation Training Academies. Am J Forensic Med Pathol 2015; 35:278-82. [PMID: 25330248 DOI: 10.1097/paf.0000000000000123] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Lack of thorough sudden unexplained infant death investigations (SUIDIs) has hindered accurate cause-of-death determination, infant mortality surveillance, and prevention strategies. To standardize SUIDI practices, the Centers for Disease Control and Prevention created a reporting form, guidelines, training curriculum, and SUIDI Training Academies using a train-the-trainer format. The training goal was to train teams of five in each state, who would reach an additional 1250 participants.The aim of this study is to evaluate the SUIDI Training Academies by determining professional characteristics of participants, assessing the level of confidence in infant death investigation components, enumerating the number of secondary trainings, and discussing recommendations for future trainings.To evaluate the training and the success of the train-the-trainer strategy, we used training evaluations, participant lists, and Web-based training logs to assess participant knowledge, skills, perceptions, and characteristics and number of secondary trainings.We trained 270 trainers at 5 SUIDI Training Academies. Greater than 96% of respondents reported confidence in case investigation skills and reported that hands-on laboratory sessions facilitated the practice of new skills. Academy trainers have trained greater than 23,000 medicolegal professionals, exceeding the training goal. This evaluation allowed us to identify opportunities to improve future SUIDI trainings.
Collapse
|
5
|
Testing for Infectious Diseases in Sudden Unexpected Infant Death: A Survey of Medical Examiner and Coroner Offices in the United States. J Pediatr 2015; 167:178-82.e1. [PMID: 25929979 DOI: 10.1016/j.jpeds.2015.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 03/05/2015] [Accepted: 04/02/2015] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To determine interoffice variability in routinely performed sudden unexpected infant death (SUID) postmortem studies for infection and to assess availability and perceived utility of various tests of infectious diseases. STUDY DESIGN Online surveys were sent to all 154 offices of US medical examiners and coroners serving populations >300,000 people. Surveys included a set of potential laboratory tests for infectious disease. Respondents were asked to select which tests were available in their offices, and which tests were performed routinely in SUIDs vs which tests should be performed routinely. RESULTS Of the 45 complete responses, 4.4% did not routinely perform histology, 8.9% did not routinely perform viral studies (ie, culture or molecular diagnostics), 22.2% did not routinely perform blood cultures, 26.7% did not routinely perform lung bacterial cultures, and 44.4% did not routinely perform cerebrospinal fluid cultures. CONCLUSIONS Our findings suggest that there is considerable interoffice variability with testing for infectious diseases in SUIDs. This appeared to be largely the result of a perceived lack of testing utility rather than a lack of test availability. Evidence-based practice guidelines regarding the interpretation of microbial testing results, as well as common testing protocols/algorithms, may lead to more accurate and standardized data, thus improving SUID investigation and surveillance.
Collapse
|
6
|
Garstang J, Ellis C, Sidebotham P. An evidence-based guide to the investigation of sudden unexpected death in infancy. Forensic Sci Med Pathol 2015; 11:345-57. [PMID: 25999133 DOI: 10.1007/s12024-015-9680-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2015] [Indexed: 11/24/2022]
Abstract
PURPOSE Many countries now have detailed investigations following sudden unexpected death in infancy (SUDI) but there is no clear evidence as to the most effective way to investigate SUDI. This systematic literature review addresses the following questions: What are the current models of practice for investigating SUDI? What is the evidence to support these investigative models? What are the key factors for effective SUDI investigation? METHODS This was a systematic review of papers from Europe, North America, and Australasia, detailing models of SUDI investigation or the outcomes of SUDI investigations. RESULTS The review includes data detailing four different models of investigation: police-led, coroner or medical examiner-led, healthcare-led or joint agency approach models. There were 18 different publications providing evidence of effectiveness of these models. All models, with the exception of police-led models, have the potential to reach best practice standards for SUDI investigation. Key factors identified for effective SUDI investigation include the need for mandatory investigation, strong leadership, integration with coronial services, and for investigations to be provided by specialist professionals. CONCLUSION Detailed SUDI investigation should lead to greater understanding of why infants die and should help prevent future deaths. The challenge is now to ensure that local SUDI investigative practices are as effective as possible.
Collapse
Affiliation(s)
- Joanna Garstang
- Division of Mental Health and Wellbeing, Warwick Medical School, Gibbet Hill Road, Coventry, CV4 7AL, UK,
| | | | | |
Collapse
|
7
|
Sudden infant death syndrome: diagnostic practices and investigative policies, 2004. Am J Forensic Med Pathol 2013; 33:197-201. [PMID: 21030849 DOI: 10.1097/paf.0b013e3181fe33bd] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Using a 2004 population-based survey of all US medical examiner and coroner offices, we examined the characteristics of offices accepting an infant death case and calculated the percentage of offices that had death scene investigation or autopsy policies for the investigation of sudden unexpected infant death (SUID). We also calculated the percentage of offices that used and did not use sudden infant death syndrome (SIDS) as a cause of death, and we compared differences in characteristics among those offices.Of medical examiner and coroner offices, 52% did not report an infant death in 2004. Of the 7957 infant deaths reported, 43% occurred in jurisdictions that experienced 1 or 2 infant deaths. Of the offices that used SIDS as a classification, 34% did not have policies for conducting death scene investigations and autopsies for SUID. At least 5% of offices that reported an infant death did not use SIDS as a cause of death classification. These findings have important implications for understanding recent trends in SIDS and SUID. Supporting the implementation of national standards for investigating and certifying infant deaths could provide guidelines for consistent practices in medical examiner and coroner offices.
Collapse
|
8
|
Shapiro-Mendoza CK, Camperlengo LT, Kim SY, Covington T. The sudden unexpected infant death case registry: a method to improve surveillance. Pediatrics 2012; 129:e486-93. [PMID: 22232303 DOI: 10.1542/peds.2011-0854] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This article describes a multistate population-based surveillance system for monitoring sudden unexpected infant deaths (SUIDs) known as the SUID Case Registry pilot program. The pilot program represents collaboration between the Centers for Disease Control and Prevention and the National Center for Child Death Review (NCCDR), which is funded by the Health Resources and Services Administration. The SUID Case Registry builds on existing child death review system activities and protocols. The objectives of the SUID Case Registry are to collect accurate and consistent population-based data about the circumstances and events associated with SUID cases, to improve the completeness and quality of SUID case investigations, and to use a decision-making algorithm with standardized definitions to categorize SUID cases. States who participate in the pilot program commit to review all SUID cases in their state by using their multidisciplinary state and local child death review teams. These teams request and review data from death scene investigators, medical examiners and coroners, law enforcement, social services, pediatric and obstetric providers, and public health per usual, but as part of the pilot program, supplement their SUID case reviews by discussing additional medical, environmental, and behavioral factors, and entering this data using the NCCDR Web-based Case Reporting System. This new surveillance system aims to improve knowledge of factors surrounding SUID events and improve investigation practices. The surveillance system will allow researchers and program planners to create prevention strategies and interventions, ultimately reducing SUIDs and injury-related infant deaths.
Collapse
Affiliation(s)
- Carrie K Shapiro-Mendoza
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | | | | |
Collapse
|
9
|
Weber MA, Sebire NJ. Post-mortem Investigation of Sudden Unexpected Death in Infancy: Role of Autopsy in Classification of Death. FORENSIC PATHOLOGY REVIEWS 2011. [DOI: 10.1007/978-1-61779-249-6_2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
|
10
|
Abstract
Sudden unexpected death is one of the most frequent ways of dying in the first year of life after the neonatal period. It is however, much less frequent after the first birthday. Investigations into the cause of death are very important, for a significant proportion of these sudden deaths can be explained only after a thorough investigation. Of the causes identified, infection is the most frequent cause; metabolic disorders and cardiovascular diseases play a role as well, although the proportion of cases is much smaller. There is now evidence that cardiac channel gene mutations also play an important role; however, identification of these conditions relies on costly testing that is not readily or widely available. The physician's role as primary care provider is critical in ensuring that families understand the results of the investigation into their child's death. It is important that everything be done to identify the cause of death so that no such tragedy recurs in the same family.
Collapse
Affiliation(s)
- Aurore Côté
- Department of Pediatrics and Respiratory Medicine Division, The Montreal Children's Hospital, McGill University Health Centre, Montreal, Canada.
| |
Collapse
|
11
|
Postmortem investigation of sudden unexpected death in infancy: current issues and autopsy protocol. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/j.mpdhp.2009.08.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
12
|
Woida FM, Saggioro FP, Ferro MAR, Peres LC. Sudden infant death syndrome in Brazil: fact or fancy? SAO PAULO MED J 2008; 126:48-51. [PMID: 18425287 PMCID: PMC11020509 DOI: 10.1590/s1516-31802008000100009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Revised: 01/29/2008] [Accepted: 01/30/2008] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE The true incidence of sudden infant death syndrome (SIDS) in Brazil is unknown. The aim here was to identify SIDS cases in the city of Ribeirão Preto, State of São Paulo, between 2000 and 2005, in order to estimate its incidence. DESIGN AND SETTING Retrospective analysis of data on live births and infant deaths in Ribeirão Preto and from autopsies of infants performed at the Death Verification Service of the Interior (SVOI) between 2000 and 2005. RESULTS There were 47,356 live births and 537 deaths, with infant mortality rates ranging from 12.9 to 10.9 of live births. Among the 24 infants who died possibly due to SIDS and who were autopsied at the SVOI, six were from families living in the municipality (0.13 of live births): three (50%) were diagnosed as SIDS, and one each (16.66%) as indeterminate cause, bronchoaspiration and cerebral edema. Two deaths occurred in the first month of life (33.33%) and one each (16.66%) at two, four, six and eight months. Two deaths each (33.33%) occurred in the months of February and December, one each in August and October (16.66%). Four cases (66.7%) occurred in the summer and one each (16.66%) in winter and spring. There was 5:1 predominance of males over females. CONCLUSIONS The frequency of SIDS was lower than what has been reported worldwide and in the Brazilian literature, thus suggesting underdiagnosis, indicating the lack of any specific postmortem protocol for SIDS identification and showing the need to implement this.
Collapse
|
13
|
Eisenstein EM, Haklai Z, Schwartz S, Klar A, Stein N, Kerem E. Investigation of unexplained infant deaths in Jerusalem, Israel 1996-2003. Arch Dis Child 2007; 92:697-9. [PMID: 17074788 PMCID: PMC2083878 DOI: 10.1136/adc.2006.107425] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Sudden infant death syndrome (SIDS) is a diagnosis of exclusion that may be assigned only after investigations including a forensic autopsy are performed to exclude possible organic and environmental causes of death. Israeli society is influenced by the Jewish and Islamic faiths, which permit autopsy only under selected circumstances. Against this background, we carried out a study to determine what examinations are performed to investigate unexplained infant deaths in Jerusalem, Israel. METHODS We examined hospital, Ministry of Health and Ministry of Interior records of unexplained infant deaths in the Jerusalem district from the years 1996-2003. RESULTS Ninety six cases were identified from all sources. Forty nine (51%) infants were brought to a hospital at or near the time of death. Studies to determine the cause of death were performed in 54% of cases for which medical records were available for review. These studies included bacterial cultures (44%), skeletal surveys (12%), computerised tomography (3%) and metabolic studies (3%). Only one forensic autopsy was performed, and in no instance was the death site examined by medical personnel. There was a high rate of retrospective review by district health physicians. The most frequently assigned cause of death was SIDS. CONCLUSIONS : The capacity of public health officials and forensic pathologists to investigate unexplained infant deaths is strongly affected by the legal, religious and political milieu in which they work. Efforts should be made to develop socially acceptable methods of improving the quality of infant death investigations in Jerusalem.
Collapse
Affiliation(s)
- Eli M Eisenstein
- Department of Pediatrics, Hebrew University-Hadassah Medical Center, Mount Scopus, Jerusalem, Israel.
| | | | | | | | | | | |
Collapse
|
14
|
Kibayashi K, Sumida T, Shojo H, Tokunaga O. Unexpected death due to intestinal obstruction by a duplication cyst in an infant. Forensic Sci Int 2007; 173:175-7. [PMID: 17236734 DOI: 10.1016/j.forsciint.2006.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 12/10/2006] [Accepted: 12/19/2006] [Indexed: 12/18/2022]
Abstract
An 11-month-old female infant died at home after being diagnosed as having gastroenteritis. Autopsy examination revealed a distended distal ileum filled with a large amount of watery contents, and a 3 cm x 3 cm x 4 cm cyst at the ileocecal part of the cecum that was histologically consistent with a duplication cyst. The cause of death was determined to be acute dehydration due to intestinal obstruction caused by a duplication cyst. This case indicates that intestinal obstruction by a duplication cyst should be recognized as a cause of unexpected death in infants.
Collapse
Affiliation(s)
- Kazuhiko Kibayashi
- Department of Forensic Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
| | | | | | | |
Collapse
|