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Rapid death following undiagnosed stercoral perforation in a chronic opioid user


Heimer, Jakob; Tappero, Carlo; Fliss, Barbara; Meixner, Eva (2020). Rapid death following undiagnosed stercoral perforation in a chronic opioid user. Legal Medicine, 42:101644.

Abstract

A case of rapid demise following an undiagnosed stercoral perforation is reported. A 57-year-old woman on chronic opioid replacement therapy presented with constipation and abdominal pain to the hospital. Following an unremarkable abdominal radiograph and admission for laxation and pain therapy, she was found dead only 18 h later. To exclude medical malpractice, a postmortem investigation was ordered. Postmortem computed tomography and autopsy revealed fatal fecal peritonitis based on a stercoral perforation of the rectosigmoid, which had been undiagnosed. This report highlights the need for early cross-sectional imaging and contributes to the data collection concerning this ever-growing, vulnerable group of patients undergoing opioid replacement.

Abstract

A case of rapid demise following an undiagnosed stercoral perforation is reported. A 57-year-old woman on chronic opioid replacement therapy presented with constipation and abdominal pain to the hospital. Following an unremarkable abdominal radiograph and admission for laxation and pain therapy, she was found dead only 18 h later. To exclude medical malpractice, a postmortem investigation was ordered. Postmortem computed tomography and autopsy revealed fatal fecal peritonitis based on a stercoral perforation of the rectosigmoid, which had been undiagnosed. This report highlights the need for early cross-sectional imaging and contributes to the data collection concerning this ever-growing, vulnerable group of patients undergoing opioid replacement.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Institute of Legal Medicine
Dewey Decimal Classification:340 Law
610 Medicine & health
510 Mathematics
Scopus Subject Areas:Health Sciences > Pathology and Forensic Medicine
Health Sciences > Issues, Ethics and Legal Aspects
Uncontrolled Keywords:Pathology and Forensic Medicine, Issues, ethics and legal aspects
Language:English
Date:1 February 2020
Deposited On:26 Feb 2020 09:11
Last Modified:22 Apr 2020 23:16
Publisher:Elsevier
ISSN:1344-6223
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.legalmed.2019.101644
PubMed ID:31759327

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