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Sudden Death by Spontaneous Epiglottic Hematoma Secondary to High Blood Levels of Warfarin.
Gilard-Pioc, Séverine; Guerard, Pascal; Paraf, François; François-Purssell, Irène.
Affiliation
  • Gilard-Pioc S; Forensic Medicine Department, Dijon University Hospital, Dijon, F-21000, France.
  • Guerard P; Pharmacology and Toxicology Laboratory, Dijon University Hospital, Dijon, F-21000, France.
  • Paraf F; Department of Forensic Medicine and Department of Pathology, Dupuytren University Hospital, 87042, Limoges, France.
  • François-Purssell I; Forensic Medicine Department, Dijon University Hospital, Dijon, F-21000, France.
J Forensic Sci ; 62(4): 1094-1096, 2017 Jul.
Article de En | MEDLINE | ID: mdl-28567968
ABSTRACT
A 67-year-old man was found dead, at his home. On external examination, we found a voluminous purplish black ecchymosis of the anterior neck area. On internal examination, we found a voluminous epiglottis hematoma completely obstructing the upper airway. It was associated with other sites of intra-abdominal hemorrhage. Toxicological studies revealed the presence of warfarin at a concentration of 8.4 mg/L in peripheral blood, which supposes an INR well above 4.5. To conclude, we supposed death was due to asphyxia secondary to a spontaneous epiglottic hematoma caused by a high blood concentration of warfarin. Hemorrhage in the epiglottis is very rare. To our knowledge, our patient is the only case of "sudden death" reported with spontaneous epiglottic hematoma due to high blood concentration of warfarin. In forensic practice, an anterior neck ecchymosis, without trauma, may suggest hemorrhage into soft airway tissues. Pathology findings make it possible to exclude exogenous trauma.
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Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Warfarine / Maladies du larynx / Mort subite / Hématome / Anticoagulants Type d'étude: Etiology_studies Limites: Aged / Humans / Male Langue: En Journal: J Forensic Sci Année: 2017 Type de document: Article Pays d'affiliation: France

Texte intégral: 1 Collection: 01-internacional Base de données: MEDLINE Sujet principal: Warfarine / Maladies du larynx / Mort subite / Hématome / Anticoagulants Type d'étude: Etiology_studies Limites: Aged / Humans / Male Langue: En Journal: J Forensic Sci Année: 2017 Type de document: Article Pays d'affiliation: France