Cirsoid aneurysm rupture of the splenic artery as a rare cause of fatal hemoperitoneum

Gentile, Guendalina; Galante, Nicola; Gobbo, Alessandro Del; Lazzaro, A.; Tambuzzi, Stefano; Zoja, Riccardo

doi:10.1016/j.jflm.2021.102134

Cited by 4 publications

(2 citation statements)

References 39 publications

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“…3 Vascular malformations such as cirsoid aneurysms, arteriovenous malformations that arise from non-capillary connections between the arterial and venous systems, are another rare cause of fatal haemorrhage. 64 Peliosis of the Figure 3. Microsopy of the spleen in a case of lethal splenic sequestration crisis showing packing of the splenic parenchyma with sickled red blood cells that are also protruding into sinuses (haematoxylin and eosin ×120) (A).…”

Section: Vascular Abnormalitiesmentioning

confidence: 99%

“…Vascular malformations such as cirsoid aneurysms, arteriovenous malformations that arise from non-capillary connections between the arterial and venous systems, are another rare cause of fatal haemorrhage. 64 Peliosis of the spleen may also represent a rare cause of splenic rupture. Peliosis is characterised by multiple blood-filled cavities without endothelial cell linings in organ parenchyma.…”

Section: Vascular Abnormalitiesmentioning

confidence: 99%

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Unexpected death involving the spleen – an overview

2023

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The spleen is located in the left upper quadrant of the abdominal cavity and has both immunological and haematological functions. A variety of quite different entities may be associated with sudden death due to splenic involvement. These range from simple traumatic disruption of the parenchyma of a normal spleen with marked intra-abdominal haemorrhage, to conditions such as malaria and infectious mononucleosis where splenomegaly predisposes to rupture. Haematological diseases such as malignancies and haemoglobinopathies may causes sudden death due to haemorrhage or red cell sequestration. Asplenia or polysplenia may be associated with significant congenital heart disease. Hyposplenia, both structural and functional, may also result in rapid demise from sometimes unusual bacterial infections. Vascular abnormalities causing death include entities such as splenic artery aneurysms. Thus, deaths from splenic pathology may be due to localised issues or may be part of more generalised disease. For this reason the autopsy in cases of splenic-associated deaths must be comprehensive and include special testing such as microbiological screening and/or haematologic/genetic evaluation.

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Section: Vascular Abnormalitiesmentioning

confidence: 99%

Section: Vascular Abnormalitiesmentioning

confidence: 99%

Unexpected death involving the spleen – an overview

2023

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Reviewing hereditary connective tissue disorders: Proposals of harmonic medicolegal assessments

Galante,

Bedeschi,

Beltrami

et al. 2024

Int J Legal Med

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Hereditary connective tissue disorders (HCTDs) are a heterogeneous group of inherited diseases. These disorders show genetic mutations with loss of function of primary components of connective tissue, such as collagen and elastic fibers. There are more than 200 conditions that involve hereditary connective tissue disorders, while the most known are Marfan syndrome, Osteogenesis Imperfecta, and Ehlers-Danlos syndromes. These disorders need continuous updates, multidisciplinary skills, and specific methodologic evaluations sharing many medicolegal issues. Marfan syndrome and Ehlers-Danlos syndromes show a high risk of early sudden death. As a consequence of this, postmortem genetic testing can identify novel genotype–phenotype correlations which help the clinicians to assess personalized cardiovascular screening programs among the ill subjects. Genetic testing is also essential to identify children suffering from Osteogenesis Imperfecta, especially when a physical abuse is clinically suspected. However, this is a well-known clinical problem even though there are still challenges to interpret genetic data and variants of unknown significance due to the current extensive use of new genetic/genomic techniques. Additionally, the more significant applications and complexities of genomic testing raise novel responsibilities on the clinicians, geneticists, and forensic practitioners as well, increasing potential liability and medical malpractice claims. This systematic review provides a detailed overview on how multidisciplinary skills belonging to clinicians, medicolegal consultants, radiologists, and geneticists can cooperate to manage HCTDs from autopsy or clinical findings to genetic testing. Thus, technical aspects need to be addressed to the medicolegal community since there is no consensus works or guidelines which specifically discuss these issues.

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