Wischnewski Ulcers and Acute Pancreatitis in Two Hospitalized Patients with Cirrhosis, Portal Vein Thrombosis, and Hypothermia

    Volume 44, Issue 5 (September 1999)

    ISSN: 0022-1198

    CODEN: JFSOAD

    Page Count: 4


    Wolf, DA
    Dade County Medical Examiner Office, Mobile, Alabama,

    Aronson, JF
    Dade County Medical Examiner Office, Miami, FL

    Veasey, SP
    Dade County Medical Examiner Office, Miami, FL

    Rajaraman, S
    Dade County Medical Examiner Office, Miami, FL

    (Received 9 October 1998; accepted 7 December 1998)

    Abstract

    Accidental hypothermia has been described in the forensic literature but reports of occurrence in hospitalized patients are rare. Associated anatomic lesions include acute hemorrhagic pancreatitis and characteristic acute gastric ulcers termed Wischnewski ulcers. We report here two patients with cirrhosis and ascites; one also had hepatocellular carcinoma. Portal vein thrombosis, acute hemorrhagic pancreatitis and Wischnewski ulcers were present in both. The clinical records documented hypothermia that progressed over several days. Temperature nadirs of 31.0°C (87.8°F) and 32.2°C (90.0°F) were recorded in each patient, respectively, one day before death, although each transiently reached temperatures that did not register on standard monitoring devices. This is the first report that chronicles antemortem body temperatures in hypothermic patients with Wischnewski ulcers and pancreatitis at autopsy. Also, the association of these findings with portal vein thrombosis and cirrhosis has not been previously described. We discuss this constellation of findings with regard to possible mechanistic interrelations.


    Paper ID: JFS12048J

    DOI: 10.1520/JFS12048J

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    Author
    Title Wischnewski Ulcers and Acute Pancreatitis in Two Hospitalized Patients with Cirrhosis, Portal Vein Thrombosis, and Hypothermia
    Symposium , 0000-00-00
    Committee E30