title: Autopsy findings for a case of acute gastric volvulus in a child.
abstract: Acute gastric volvulus resulting in abdominal compartment syndrome was determined to be the cause of death in a 4-year-old girl who presented with abdominal distension. At about 1AM on the day of her death, she was brought to our emergency medical center. Physical examination and plain abdominal X-ray revealed pronounced gastric dilatation. A decompression procedure was performed, followed by observation. She went into cardiopulmonary arrest around 1PM on the same day and died. Postmortem investigation, including an autopsy and computed tomography (CT), was performed to determine the cause of death. The findings included that the stomach was severely distended. Evidence was seen of mucosal hemorrhage in the gastric mucosa on the greater curvature side, which was thinned in places but without perforation. No necrosis of the gastric mucosa was observed; reversible changes were evident on histopathological examination. The postmortem CT images suggested that the pyloric region was positioned cranioventrally to the cardiac region. None of the findings indicated sudden blockage, and the cause of death was determined to be acute gastric volvulus resulting in abdominal compartment syndrome. The abnormal placement of the organs was difficult to determine based on physical examination alone; postmortem CT and careful examination were helpful in conducting the autopsy in this case.
authors.affiliation: Department of Forensic Medicine and Sciences, Mie University Graduate School of Medicine, Japan. Electronic address: skozawa@doc.medic.mie-u.ac.jp.
authors.forename: Shuji
authors.initials: S
authors.lastname: Kozawa
authors.affiliation: Department of Radiological Science, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Division of Legal Medicine, Department of Social Medicine, Faculty of medicine, University of Miyazaki, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Kakizaki
authors.affiliation: Department of Forensic Medicine and Sciences, Mie University Graduate School of Medicine, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Ikemura
authors.affiliation: Department of Forensic Medicine and Sciences, Mie University Graduate School of Medicine, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Department of Forensic Medicine and Sciences, Mie University Graduate School of Medicine, Japan.
authors.forename: Yuma
authors.initials: Y
authors.lastname: Kiyofuji
authors.affiliation: Division of Forensic Pathology and Science, Unit of Social Medicine, Course of Medical and Dental Sciences, Graduate School of Biomedical Sciences, Nagasaki University School of Medicine, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ikematsu
authors.affiliation: Department of Forensic Medicine and Sciences, Mie University Graduate School of Medicine, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Nata
mesh_terms: D000208:Acute Disease; D001344:Autopsy; D002423:Cause of Death; D002675:Child, Preschool; D005260:Female; D006801:Humans; D059325:Intra-Abdominal Hypertension / Q000209:etiology / Q000473:pathology*; D013277:Stomach Volvulus / Q000150:complications / Q000473:pathology*; D014057:Tomography, X-Ray Computed
keywords: Abdominal compartment syndrome; Acute abdomen; Gastric volvulus; Postmortem computed tomography