A 17-year-old male with a history of paraplegia secondary to a gunshot wound at the T1 vertebra.
She died at home without medical assistance, so a forensic autopsy was ordered.
a) Pain in the external face: a) pain in the extremities and ankylosis of the hands; pressure ulcers with necrotic tissue at the bitrochanteric and sacral level.
Placement of neck dissection.
She had a urinary catheter connected to a collection bag containing urine with a striking purple color.
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(b) internal fixation: an encephalon with marked weight gain (1.875 g) with a pattern of cerebral oedema (planning of the jaws and surroundings).
Normal weight heart (325 g) with mild dilation of right heart cavities and presence of mural thrombi.
Right pleural and interlobular adhesions and pulmonary thromboembolism in the left branch of the pulmonary artery.
Slightly high weight (D: 640 g; I: 600 g) with moderate to severe edema and congestion pattern.
Pulmonary infarction was not observed.
Kidneys of normal weight (D: 180 g; I: 130 g) with scarce corticomedullary differentiation, hemorrhage in the medullary area and areas of renal pigmentation through the exit of purulent material.
In the urinary bladder 400 cc of cloudy urine, fetid odor associated with sediment in its bottom coloration cream with purulent aspect were quantified.
1.
(c) Complementary fixations:
- Negative toxicological analysis in blood, urine and vitreous humor samples.
- Microbiological analysis.
Urinary sediment culture showed growth of Proteus vulgaris.
(d) Cause of death: it was considered that pulmonary thromboembolism was the immediate cause of death, urinary tract infection as the intermediate cause and paraplegia as the main cause.
