A 45-year-old woman was found dead on a sofa in her flat by her male partner. She was known as a chronic alcoholic with nearly three decades of heavy alcohol abuse and more than 40 clinical treatments for alcohol withdrawal in her previous medical history. Because of the young age of the deceased, the unknown circumstances surrounding her death and both an undetermined cause and manner of death, a medicolegal autopsy was performed.External examination of the body showed an overweight adult female (body mass index: 29) without any external injuries. At autopsy, all inner organs appeared pale. Several mucosal lacerations of the lower esophagus were present. 150 ml of bloody fluid were found in the stomach. A large amount of tarry stool was present in the small and large bowel. In addition, edema of the lungs and fatty liver were seen. The most remarkable finding was a region of gray and light brownish discoloration, measuring 1 cm in diameter, that was located in the middle of the base of the pons within the brainstem, corresponding to central pontine myelinolysis (CPM) (Figs. 1, 2). Histology of the pons lesion verified the diagnosis of CPM by revealing demyelinization with reactive astrocytes and large numbers of foamy lipid-laden macrophages and scanty lymphocytes (Figs. 3, 4).Toxicology results were negative for both alcohol and drugs.Death was attributed to exsanguination due to MalloryWeiss syndrome of the lower esophagus.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.