Wischnewski ulcers and acute pancreatitis in two hospitalized patients with cirrhosis, portal vein thrombosis, and hypothermia

Dwayne A. Wolf, Judith F. Aronson, Srinivasan Rajaraman, Sparks P. Veasey

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Accidental hypothermia has been described in the forensic literature but reports of occurrence in hospitalized patients are rare. Associated anatomic lesions include acute hemorrhagic pancreatitis and characteristic acute gastric ulcers termed Wischnewski ulcers. We report here two patients with cirrhosis and ascites; one also had hepatocellular carcinoma. Portal vein thrombosis, acute hemorrhagic pancreatitis and Wischnewski ulcers were present in both. The clinical records documented hypothermia that progressed over several days. Temperature nadirs of 31.0°C (87.8°F) and 32.2°C (90.0°F) were recorded in each patient, respectively, one day before death, although each transiently reached temperatures that did not register on standard monitoring devices. This is the first report that chronicles antemortem body temperatures in hypothermic patients with Wischnewski ulcers and pancreatitis at autopsy. Also, the association of these findings with portal vein thrombosis and cirrhosis has not been previously described. We discuss this constellation of findings with regard to possible mechanistic interrelations.

Original languageEnglish (US)
Pages (from-to)1082-1085
Number of pages4
JournalJournal of Forensic Sciences
Volume44
Issue number5
DOIs
StatePublished - Sep 1999

Keywords

  • Acute hemorrhagic pancreatitis
  • Forensic pathology
  • Forensic science
  • Hospitalized patients
  • Hypothermia
  • Wischnewski ulcers

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Genetics

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