External bleeding from femoro-crural vein bypass with aneurysmal dilation. (March 2023)

• Record Type: Journal Article
• Authors: Jacobi, Sindy; Heide, Steffen; Reeps, Christian; Pablik, Jessica; Lutz, Brigitta
• Is Part Of: Legal medicine. Volume 61(2023)
• Publication Date: 2023-03
• Subjects: Fatal bleeding -- Bleeding source -- Bypass rupture -- Venous bypass -- Peripheral arterial occlusive disease; Medical jurisprudence -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Medical jurisprudence; Periodicals; 614.1
• DOI: 10.1016/j.legalmed.2023.102217
• Languages: English
• ISSNs: 1344-6223

Abstract

Highlights: Death of a 64-year-old man as a result of rupture of a femoro-crural bypass. The rupture originated from a rare true aneurysm of an autologous femoro-crural vein bypass. The aneurysm rupture passed all subcutaneous and skin layers leading to fatal external bleeding. Abstract: Deaths due to external bleeding outside the hospital setting are often suspected to involve violence. However, some disease-related causes, can also lead to fatal external bleeding. While bleeding from natural body orifices is a common end stage of non-curable gastrointestinal bleeding, fatal bleeding via newly formed skin defects is quite rare and highly suspicious in light of external impact. Reliable clarification of the source and cause of bleeding is only possible in the context of an autopsy. The reported case involves the death of a man early 60 s who bled to death as a result of rupture of a femoro-crural bypass. The rupture originated from a rare true aneurysm of an autologous femoro-crural vein bypass implanted 8 years before due to peripheral arterial occlusive disease (PAD) with gangrene. The aneurysm rupture passed all subcutaneous and skin layers leading to fatal external bleeding.