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Fatal Ischemic Enteritis with HemorrhageA Late Complication of Treated Wilms Tumor

NCJ Number
243760
Journal
Journal of Forensic Sciences Volume: 58 Issue: 1 Dated: January 2013 Pages: 234-236
Author(s)
John D. Gilbert, F.R.C.P.A.; Roger W. Byard, M.D.
Date Published
January 2013
Length
3 pages
Annotation
This study examined the death of a 35-year-old man with a history of childhood Wilms tumor.
Abstract
A 35-year-old man with a history of childhood Wilms tumor successfully treated with radiotherapy, chemotherapy, and surgery, collapsed and died unexpectedly in hospital following admission for abdominal pain. At autopsy, there was ischemic necrosis of the small intestine with altered blood within the stomach and small intestine. Within the upper abdominal aorta, there was patchy confluent calcific atherosclerosis with extension into the proximal superior mesenteric artery which was occluded by thrombus. Death was attributed to ischemic enteritis of the small intestine caused by mesenteric artery thrombosis complicated by gastrointestinal hemorrhage with aspiration. Localization of atherosclerosis to the radiation field with no significant atherosclerosis elsewhere and the young age of the decedent were supportive of radiation-induced atherogenesis. Geographically, localized atherosclerosis at autopsy in a tumor survivor should raise the possibility of a treatment-related side effect that may directly contribute to death many years after the original therapeutic intervention. Abstract published by arrangement with John Wiley & Sons.