Aug 19, 2015
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Can someone please review this pathology report. The deceased was a friend of mines daughter. The desceased was a 32yr old female. No serious previous medical history Had a baby not even two years before she died. She went to the hospital because she became jaundiced. She was told her liver was failing and was sent home. She went back to the hospital a month later with worsening symptoms and was sent home again. A week and a half later she was found in her home disoriented and was rushed to the hospital where she had cholangitis or cholecytitis I believe. She had sepsis went into to septic shock and died 26 days later. No one is really sure what happened to her. I attached pics of the pathology report. No CNS
 

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jkdoctor

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"No serious previous medical history"

She had cirrhosis of the liver and appears to have had splenomegsly and ascites from what I can tell.
I believe cirrhosis of the liver is a very serious medical problem.
Tell us what caused her to have cirrhosis?

Was she an alcohol user? Was she obese? Did she contract Hepatitis B or C from a partner?
Imo people with advanced liver cirrhosis are a setup for premature death.
 
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Aug 19, 2015
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"No serious previous medical history"

She had cirrhosis of the liver and appears to have had splenomegsly and ascites from what I can tell.
I believe cirrhosis of the liver is a very serious medical problem.
Tell us what caused her to have cirrhosis?

Was she an alcohol user? Was she obese? Did she contract Hepatitis B or C from a partner?
Imo people with advanced liver cirrhosis are a setup for premature death.
No
 
Aug 19, 2015
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When I say no previous medical history I mean she wasn't diagnosed with cirrhosis until her liver suddenly failed
 
Aug 19, 2015
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I was saying based off here gross appearance and microscopic examination what does it sound like. There are things that can be indicative of certain disease based of these findings. Obviously she had cirrhosis and ascites anyone can figure that out.
 
Aug 19, 2015
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For instance it shows she had thyroid disease, macronodular cirrhosis in the left lobe ect. The doctors really are
Not sure what caused it. That's what I'm asking.... Apparently this is a trend
 

cmz

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I was saying based off here gross appearance and microscopic examination what does it sound like. There are things that can be indicative of certain disease based of these findings. Obviously she had cirrhosis and ascites anyone can figure that out.
Once you see cirrhosis, you will have a difficult to almost impossible task of establishing what caused it. Her symptoms of jaundice and altered mental status confirm the clinical picture of advanced liver disease.
 
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Ya no one is debating whether she had advanced liver disease. But as you can see her liver had a gross appearance of red brown and smooth capsular surface and macro nodular cirrhosis in the left lobe shown in the cut surface. Along with bridging fibrosis
 
Aug 19, 2015
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Her liver size was normal as well. There are certain characteristics of all eitologys of liver disease
 
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pathstudent

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Condolences on the loss of your friend. We cannot, however, offer any medical advice or interpretation on SDN. It's explicitly against the forum rules.

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I question whether commenting on an autopsy report constitutes medical advice. You can't perform medicine on the dead.

But having said that I would suggest to the original poster that you are better off having a family member contact the pathologist who released the autopsy report. He or she will be the best person to put it all together. That's my "medical advice"
 

yaah

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Contact the pathologist or physician.

The autopsy says there was cirrhosis (which is end stage liver disease - does not happen suddenly). Might be something congenital which could be illuminated by family history. There are many hereditary causes of cirrhosis. It's usually caused by alcohol or hepatitis C or steatohepatitis but there are many other causes. The proximal cause of death looks likely related to significant pulmonary failure related to infection (possibly with other etiologies). This was probably acquired in the last few weeks of life, whether there was an underlying lung disease that it was superimposed on also I have no idea, another reason to contact the pathologist or physician.
 
Aug 19, 2015
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She was in septic shock for a week. She had cholecystitis and was cured by a stent placement in her cystic duct. She recovered but her kidneys failed during he sepsis. They wanted to place a permacath by her neck for dialysis in the event her kidneys didn't come back. She had a temp cath in on her thigh but they said it was more susceptible to infection a couple days after sepsis she was extubated where she regained consciousness and started eat and drinking fluids. She still had a high inr of 3.4 so they gave her 4 units of ffp to lower her inr for the surgery. The surgery got canceled that day and was to be performed the following day. They have her 4 more units of ffp the next morning.they did not have her on dialysis during these days. After the surgery she went to recover and became tachycardic and started spitting up up pink frothy sputum an X-ray was taken showing a complete whiteout of her lungs. Not even a day later her rr went up so high they had to intubated her again. It's obvious that she had a chronic liver disease its just odd that it never poked its had until it failed and at such a young age
 
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autopsies arent the practice of medicine, ergo pathologists should not be expected to do them(barring forensics). i dont do them.
 

mikesheree

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For instance it shows she had thyroid disease, macronodular cirrhosis in the left lobe ect. The doctors really are
Not sure what caused it. That's what I'm asking.... Apparently this is a trend
Wilson's dz may present as unexpected /unsuspected /cryptogenic cirrhosis at the time of hepatic failure or sudden death but is not a very high diagnostic yield. Just something to consider.
 
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