An 87-year-old woman with a history of chronic hepatitis C and hypertension and no history of previous abdominal trauma, who presented with a nonspecific picture of general malaise, nausea and vomiting for several hours of evolution, was attended at home.
She died within a few hours of medical care, which is why a forensic autopsy was performed.
External examination revealed cutaneous-mucosal dryness and a butterfly arrangement of the second toes of both feet.
During the internal examination, mitral calcification, coronary atheromatosis with obstruction of the same between 25-50%, concentric ventricular hypertrophy, generalized atheromatosis of the great vessels and partially coagulated hemoperitoneum of 3,000 were detected.
Liver with a weight of 1,585 g in which macroscopically a generalized macronodular cirrhosis was observed. In the left spherical tumor, the diameter of the liver lobe was very mobile, with a greyish, partial rupture.
At the cut, it was observed that the hepatic tumor had a paler color than the surrounding tissue, of heterogeneous appearance, scarce pigmentation, necrotic zone, biliary rupture a.
Histopathology of the tumor reported a high-grade hepatocellular carcinoma.
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The cause of death was interpreted as a consequence of hypovolemic shock secondary to hemoperitoneum due to rupture of hepatocellular carcinoma (according to ICD 10: C22.0).
This type of complication is extremely rare in our environment.
