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https://hdl.handle.net/2440/52100
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Type: | Journal article |
Title: | Megaesophagus and Possible Mechanisms of Sudden Death |
Author: | Schalinski, S. Guddat, S. Tsokos, M. Byard, R. |
Citation: | Journal of Forensic Sciences, 2009; 54(1):216-219 |
Publisher: | Amer Soc Testing Materials |
Issue Date: | 2009 |
ISSN: | 0022-1198 1556-4029 |
Statement of Responsibility: | Sarah Schalinski, Saskia S. Guddat, Michael Tsokos, and Roger W. Byard |
Abstract: | Achalasia is a neurodegenerative condition characterized by esophageal dysmotility and megaesophagus. Two cases are reported that demonstrate unexpected deaths associated with previously unsuspected achalasia. Case 1: A 66-year-old woman was found dead at her home. At autopsy significant stenosing coronary artery atherosclerosis was found with cardiac failure. In addition, a striking finding was narrowing of the distal esophagus with marked proximal dilatation. The esophagus was completely filled with a large amount of soft masticated food and was bulging anteriorly, compressing the left atrium. Death was attributed to ischemic heart disease complicated by previously unsuspected achalasia. Case 2: An 84-year-old man collapsed and suffered a respiratory arrest while eating. Internal examination revealed narrowing of the cardioesophageal junction with marked proximal dilatation of the esophagus that contained approximately 50 mL of soft semi-fluid masticated yellow food paste. Fragments of yellow masticated food remnants were present in upper and lower airways but not within the stomach. There was a history of dementia with symmetrical cerebral ventricular dilatation found at autopsy. Death was attributed to food asphyxia complicating previously unsuspected achalasia with dementia. Megaesophagus may, therefore, be a significant finding at autopsy that may either be a primary cause of unexpected death or else may exacerbate or compound the effects of pre-existing underlying disease. |
Keywords: | forensic science megaesophagus achalasia sudden death aspiration arrhythmia mechanisms |
DOI: | 10.1111/j.1556-4029.2008.00912.x |
Published version: | http://dx.doi.org/10.1111/j.1556-4029.2008.00912.x |
Appears in Collections: | Aurora harvest Pathology publications |
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