RESUMEN Tradicionalmente, la Medicina Forense ha tenido que dilucidar las causas del óbito en algunas muertes naturales; en particular, aquellos casos en que el fallecimiento ocurría de forma súbita o repentina y el sujeto, real o aparentemente, gozaba de buena salud. Desde la década de los 80, el número de muertes naturales autopsiadas en el curso de Diligencias Judiciales aumenta de forma paulatina, a expensas de las defunciones que ocurren a consecuencia de complicaciones de tratamientos aplicados y posibles negligencias médicas. El síndrome de embolismo por cristales de colesterol, es una entidad poco frecuente, que aparece principalmente en varones mayores de 60 años con arteriosclerosis generalizada, tras la realización de procedimientos angiográficos, cirugía vascular, o más raramente, con tratamiento anticoagulante oral, heparina o fibrinolíticos. Lo inusual del caso y sus consecuencias fatales, pueden ser de difícil comprensión a un profano, hecho que induce con facilidad a denunciar una posible malpraxis. En el presente trabajo se expone un caso estudiado por nosotros, tras denuncia judicial, detallando el cuadro clínico, examen macro y microscópico y una revisión de la literatura. Palabras clave: Trombolisis, embolismo por cristales de colesterol, malpraxis. ABSTRACT Traditionally Forensic medicine has had to explain the reasons for demise in occasional natural deaths; especially those cases in which death occurred suddenly and the subject enjoyed real or apparent good health. Since the decade of the 80s, the number of deaths autopsied in the course of Judicial Formalities has increased slowly at the expense of deaths which occur as a consequence of complications in applied treatments and possible medical negligence. Embolism caused by cholesterol crystals is an infrecuent entity, which appears principally in men older than 60 with widespread arteriosclerosis after angiographic procedures, vascular surgery, or, varely, upon the use of anticoagulative oral treatment, heparina or thrombolytics. The rareness of suc a case and its fatal consequences may be difficult for a layman to comprehend, a fact that easily leads to a charge of possible malpraxis. In the present work we explain a case studied by us after judicial charges, detailing the clinical picture, macro and microscopic examination and a review of the literature.
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