title: Sudden death of a child because of an intestinal obstruction caused by a large congenital mesenteric defect.
abstract: Transmesenteric hernias are internal hernias caused by a congenital defect in the mesentery. They are rare causes of intestinal obstruction, but most commonly affect the small bowel. We report an unexpected death of an infant with a bowel obstruction caused by a congenital mesenteric defect, which was undiagnosed despite visits to three different hospitals. Mesenteric defects are usually 2-3 cm in diameter. At autopsy, we found an oval, 14 × 7 cm congenital defect in the ileal mesentery through which the small bowel had herniated. Diagnosis of such defects remains difficult, even with currently available imaging techniques. Diagnosis is particularly difficult in infants who usually have nonspecific symptoms. Therefore, it is important that sudden unexpected deaths in children undergo full forensic evaluation to establish the precise cause of death. It is also important for forensic physicians to inform clinicians of the risk of such diseases, particularly in emergency situations.
authors.affiliation: Department of Legal Medicine, Osaka Medical College, Takatsuki, Japan. leg017@art.osaka-med.ac.jp
authors.forename: Takako
authors.initials: T
authors.lastname: Sato
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Abe
authors.forename: Kento
authors.initials: K
authors.lastname: Tsuboi
authors.forename: Misa
authors.initials: M
authors.lastname: Iwata
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Tamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Tsuchihashi
authors.forename: Hajime
authors.initials: H
authors.lastname: Nishio
authors.forename: Koichi
authors.initials: K
authors.lastname: Suzuki
mesh_terms: D001344:Autopsy; D003645:Death, Sudden; D017809:Fatal Outcome; D006547:Hernia / Q000473:pathology*; D006801:Humans; D007223:Infant; D007415:Intestinal Obstruction / Q000473:pathology*; D007564:Japan; D008297:Male; D008638:Mesenteric Arteries / Q000002:abnormalities*