Summary
A 20-year-old woman was treated because of her complaint and symptoms which were thought to be the results or complication of her pregnancy. Based on the cardinal symptom inferior cavography was carried out, and the diagnosis of occlusion of inferior vena cava was established. The woman was treated accordingly but died after a short period. The patient's family supposed neglection and therapeutic misadventure and raised an objection to the medical treatment. Forensic autopsy was carried out to clear up the case. Autopsy showed her basic disease to be gastric cancer with several metastases in the liver. One of them was in the lobus caudatus Spigeli and compressed the inferior vena cava. The compression caused a turbulence in the given contrast material so that thrombosis was suggested. The diagnosis was based on this misleading sign. Negligence was not verified.
Zusammenfassung
Bei einer 20-jährigen schwangeren Frau wurde wegen ihrer Beschwerden eine Angiographie der Vena cava inferior durchgeführt. Es wurde ein Stop in dem Gefäß gefunden. Dieser Befund wurde mit der Schwangerschaft in Zusammenhang gebracht. Es wurde eine thrombolytische Therapie begonnen. Die Patientin verstarb bald darauf. Die Familie der Patientin hat ein ärztliches Versäumnis angenommen und Klage erhoben. Um den Vorwurf zu klären, wurde eine gerichtsmedizinische Obduktion durchgeführt. Bei der Obduktion wurde ein Magenkarzinom mit Lebermetastasen als Grundkrankheit gefunden. Eine Metastase im Lobus caudatus Spigeli komprimierte die Vena cava inferior. Dieser Befund führte zur Fehldiagnose Thrombose. Aufgrund des Ergebnisses der Obduktion war die Klage völlig unbegründet.
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Varga, M., Buris, L. Vena occlusive disease simulated by a metastasis of gastric cancer during pregnancy. Z Rechtsmed 97, 219–222 (1986). https://doi.org/10.1007/BF00201245
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DOI: https://doi.org/10.1007/BF00201245