title: Autopsy findings of a patient with rapidly progressive massive ascites caused by alcoholic cirrhosis.
abstract: A 54-year-old man, who lived alone, was hospitalized due to rapid deterioration of the general condition over a three-week period caused by alcoholic cirrhosis. One month after he left hospital, he was found dead in his house by his friend. Three days before he was found dead, he had met his friend and seemed to be in poor condition. Autopsy was conducted by a medical examiner to clarify the cause of death. Externally, signs of severe jaundice were apparent over the whole body, along with extensive abdominal swelling and edema of the extremities. Autopsy findings demonstrated that the abdominal cavity contained an amount of massive turbid and slight pale reddish brown ascites (23 l). There were no findings of severe peritoneal inflammation. The liver (650 g) was elastic hard and had a micro-nodular surface, which showed severe atrophy. Microscopic examination of the liver showed clear pseudolobule with severe fibrosis in the stroma. There were no significant changes in the heart or brain. The stomach was empty and only a slight amount of intestinal contents. There was no ethanol detected in the blood or urine. The direct cause of his death was circulatory dysfunction due to massive accumulation of the ascites. The reasons for the massive ascites accumulation over 20 l in this case were (1) that he had no serious complications other than ascites; and (2) he did not have any medical treatment just before his death.
authors.affiliation: Section of Forensic Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8519, Japan.
authors.forename: Kanako
authors.initials: K
authors.lastname: Noritake
authors.forename: Kana
authors.initials: K
authors.lastname: Unuma
authors.forename: Akina
authors.initials: A
authors.lastname: Nara
authors.forename: Kyoko
authors.initials: K
authors.lastname: Uchida
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Shiratori
authors.forename: Yumi
authors.initials: Y
authors.lastname: Watanuki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Funakoshi
authors.forename: Koichi
authors.initials: K
authors.lastname: Uemura
mesh_terms: D001201:Ascites / Q000209:etiology*; D001344:Autopsy; D017809:Fatal Outcome; D006801:Humans; D007564:Japan; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged