title: An unexpected death due to massive ascites and a giant mucinous ovarian cystadenoma.
abstract: A female in her thirties fell face down in her room. She was motionless when her sister found her. She was transported to the hospital by ambulance and was in a state of cardiopulmonary arrest on admission. She did not respond to resuscitation. Her abdomen had started to swell 3years before her death. An autopsy was performed to clarify the decedent's cause of death. She was 172cm tall and weighed 146kg. Her maximum abdominal girth was 172.1cm. A subcutaneous hemorrhage measuring 4.5cm in diameter was observed in the epigastric region. The abdominal cavity contained brownish ascites (54.1L). The left ovary was markedly swollen, and the combined weight of the uterus and right ovary was more than 13.0kg. A left ovarian tumor consisting of serous and mucinous cysts was detected. There were no metastatic lesions in the peritoneum or other organs. She might have suffered circulatory disturbance caused by the ascites and ovarian tumor. Moreover, being in a prone position would have resulted in an increase in intra-abdominal pressure, further exacerbating her circulatory problems. Therefore, her cause of death was considered to be circulatory failure caused by significant ascites and a large ovarian tumor.
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. Electronic address: kasiwagi@fukuoka-u.ac.jp.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Kashiwagi
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
authors.forename: Mio
authors.initials: M
authors.lastname: Takayama
authors.affiliation: Kobe City Medical Center General Hospital Emergency Department, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe 650-0047, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Sugimura
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Matsusue
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Hara
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
authors.forename: Brian
authors.initials: B
authors.lastname: Waters
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan.
authors.forename: Shin-Ichi
authors.initials: SI
authors.lastname: Kubo
mesh_terms: D000328:Adult; D001201:Ascites / Q000473:pathology*; D018291:Cystadenoma, Mucinous / Q000473:pathology*; D003645:Death, Sudden; D005260:Female; D006801:Humans; D010538:Peritonitis
keywords: Circulatory failure; Giant ovarian tumor; Massive ascites; Mucinous ovarian cystadenoma; Peritonitis