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BackgroundVaricose veins are a common entity presenting a worldwide distribution. Although they are usually benign, sometimes are proved to be a threatening condition. Massive hemorrhage is an unusual complication of this common venous pathology that demands immediate medical intervention.Case presentationWe present a case of a 66-year-old woman found dead in her house surrounded by a large quantity of blood. Autopsy revealed a 7 mm ulcer on the internal surface of the left lower leg communicating with a varicose vein, signs of exsanguinations and liver cirrhosis. Toxicological analysis was negative.ConclusionMassive hemorrhage from a ruptured varicosity is a severe medical emergency. Awareness of the risk of massive hemorrhage may provoke preventive treatment to be undertaken so as terminal loss of consciousness and a subsequent unattended death to be averted.

The most abundant volatiles detected during the forensic ethanol analysis are ethanol, acetaldehyde, 1-propanol, 2-propanol, and acetone. These volatiles could either be initiated in the human body after the consumption of alcoholic beverages; or have been produced ante mortem during metabolic processes or post-mortem by microbes. Aims of this study were the determination of the volatiles' concentrations in autopsy blood samples received from 483 routinely autopsied corpses and classification of their patterns according to the manner of death, and the presence of putrefaction at autopsy. The volatiles concentrations were determined by a validated gas chromatographic method. The experimental values obtained from these determinations were submitted to statistical evaluation by principal component analysis (PCA). Blood acetaldehyde, acetone, 1-and 2-propanol concentrations were higher in cases of violent and undetermined deaths compared to the ones determined in cases of natural deaths. Blood volatiles concentrations were dispersed in higher values in cases with putrefaction compared to cases without putrefaction at autopsy. Blood volatiles had low values in the majority of cases with low BAC. All volatiles had higher maximum concentrations and broader concentration ranges when BAC ranged from 10-100 mg/ dL. Cases of undetermined manner of death along with some cases of violent deaths achieved clustering (PCA) from cases of violent or natural manner of death indicating similarities among the grouped samples on the basis of measured blood 1-propanol and ethanol concentrations. The latter novel finding needs further investigation using a larger dataset pool and possibly other classification method with a different regression model.

We report a case of a rare complication of Laparoscopic Adjustable Gastric Banding (LAGB) as a cause of death in the immediate post-operative period. The number of relevant reports and postmortem images presented in the literature is extremely restricted. Gastric necrosis may constitute a cause of death after LAGB in the early post-operative period. Postmortem examination reveals the extension of gastric ischemia and necrosis, responsible for the lethal outcome. To date, only one case of gastric necrosis after LAGB in the immediate post-operative period leading to death has been reported, according to authors' knowledge. The diagnosis of this complication may be delayed on the grounds of its rarity. In our opinion, surgeons should be aware of the clinical state implying gastric ischemia early after LAGB, so as to recognize and, in turn, to treat it promptly.