<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE root>
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="research-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Russian Journal of Forensic Medicine</journal-id><journal-title-group><journal-title xml:lang="en">Russian Journal of Forensic Medicine</journal-title><trans-title-group xml:lang="ru"><trans-title>Судебная медицина</trans-title></trans-title-group></journal-title-group><issn publication-format="print">2411-8729</issn><issn publication-format="electronic">2409-4161</issn><publisher><publisher-name xml:lang="en">Eco-Vector</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">16180</article-id><article-id pub-id-type="doi">10.17816/fm16180</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Case reports</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Экспертная практика</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="zh"><subject>临床病例报告</subject></subj-group><subj-group subj-group-type="article-type"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">Sudden death due to right fallopian tube tear in ectopic pregnancy: an autopsy-based case report</article-title><trans-title-group xml:lang="ru"><trans-title>Внезапная смерть по причине разрыва правой фаллопиевой трубы вследствие внематочной беременности: описание клинического случая на основе заключения судебно-медицинской экспертизы</trans-title></trans-title-group><trans-title-group xml:lang="zh"><trans-title>因异位妊娠导致右侧输卵管破裂引发猝死： 基于法医学尸检的病例描述</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-3058-146X</contrib-id><name><surname>Syahroni</surname><given-names>Syahroni S.</given-names></name><address><country country="ID">Indonesia</country></address><bio><p>MD</p></bio><email>syahronibinmukin19@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0006-1914-3986</contrib-id><name><surname>Ongko</surname><given-names>Wira Santoso</given-names></name><address><country country="ID">Indonesia</country></address><bio><p>MD</p></bio><email>wiraongko@gmail.com</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4754-768X</contrib-id><name><surname>Yudianto</surname><given-names>Ahmad</given-names></name><address><country country="ID">Indonesia</country></address><bio xml:lang="en"><p>MD, Dr. (Medicine), Professor</p></bio><bio xml:lang="ru"><p>д-р. мед. наук, профессор</p></bio><bio xml:lang="zh"><p>MD, Dr. (Medicine), Professor</p></bio><email>yudi4n6sby@yahoo.co.id</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff id="aff1"><institution>Airlangga University</institution></aff><pub-date date-type="preprint" iso-8601-date="2025-01-24" publication-format="electronic"><day>24</day><month>01</month><year>2025</year></pub-date><pub-date date-type="pub" iso-8601-date="2024-12-29" publication-format="electronic"><day>29</day><month>12</month><year>2024</year></pub-date><volume>10</volume><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><issue-title xml:lang="zh"/><fpage>602</fpage><lpage>610</lpage><history><date date-type="received" iso-8601-date="2024-08-17"><day>17</day><month>08</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2024-10-09"><day>09</day><month>10</month><year>2024</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2024, Eco-Vector</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2024, Эко-Вектор</copyright-statement><copyright-statement xml:lang="zh">Copyright ©; 2024,</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="en">Eco-Vector</copyright-holder><copyright-holder xml:lang="ru">Эко-Вектор</copyright-holder><ali:free_to_read xmlns:ali="http://www.niso.org/schemas/ali/1.0/" start_date="2026-12-29"/></permissions><self-uri xlink:href="https://for-medex.ru/jour/article/view/16180">https://for-medex.ru/jour/article/view/16180</self-uri><abstract xml:lang="en"><p>Ectopic pregnancy complications, particularly those that cause rupture, can lead to sudden and critical situations. Sudden death cases should be approached as unnatural deaths until proven otherwise through scientific investigations. An autopsy is a key method conducted by a forensic and medicolegal pathologist for establishing the cause of death.</p> <p>This case report presents a suspected case of unnatural death being investigated by the police. A young, unmarried woman living alone was found dead in her room, with no clear medical history. A forensic autopsy was performed to determine the cause of death. The findings revealed an enlarged uterus, a tear in the right fallopian tube, and a blood human chorionic gonadotropin level of 5,224.07 mIU/mL. Supported by histopathological findings through an overview that shows the existence of tubal ectopic pregnancy. Moreover, severe internal bleeding in the abdominal cavity due to a tear in the right fallopian tube was noted, which led to hemorrhagic shock caused by a 1,946.7 ml blood loss. Thus, the patient experienced multiple-organ failure, indicated by lung edema and kidney and stomach necrosis observed during a histopathological examination. The victim’s sudden death was a result of a natural cause, which was determined after eliminating other possibilities.</p></abstract><trans-abstract xml:lang="ru"><p>Осложнения внематочной беременности, особенно связанные с разрывом анатомических структур, могут приводить к внезапным критическим состояниям. Случаи внезапной смерти по умолчанию считаются насильственными, пока экспертиза не докажет обратное. Вскрытие является ключевым методом, проводимым судебно-медицинским экспертом для установления причины смерти.</p> <p>В данной статье представлен предполагаемый случай неестественной смерти, который расследуется полицией. Молодая незамужняя женщина, проживавшая одна, была найдена мёртвой в своей комнате. Для установления причины смерти проведена судебно-медицинская экспертиза, по результатам которой обнаружены увеличенная в размерах матка и разрыв правой фаллопиевой трубы. Уровень β-хорионического гонадотропина человека в крови составил 5224,07 мМЕ/мл. Наличие внематочной трубной беременности подтверждено заключением гистопатологического исследования. Обнаружено также массивное кровоизлияние из места разрыва правой фаллопиевой трубы в брюшную полость с общим объёмом кровопотери 1946,7 мл, которое привело к развитию геморрагического шока. При гистопатологическом исследовании выявлены отёк лёгких, некроз почек и желудка, что свидетельствует о полиорганной недостаточности. Путём исключения других вариантов было установлено, что внезапная смерть наступила по естественным причинам.</p></trans-abstract><trans-abstract xml:lang="zh"><p>异位妊娠的并发症，特别是与解剖结构破裂相关的情况，可能导致突发的危急状态。猝死通常被默认视为暴力死亡，直到法医学证据证实相反结论为止。尸检是法医专家确定死因的关键方法。</p> <p>本报告展示了一个疑似非自然死亡案例，该案正在由警方调查。一名年轻的单身女性独居，被发现死于其房间内；既往病史不详。为确定死因，进行了法医学尸检。尸检发现子宫增大及右侧输卵管破裂；血液β-人绒毛膜促性腺激素（β-hCG）水平为5224.07 mIU/ml。通过组织病理学检查确诊为异位妊娠（输卵管妊娠）。此外，还发现右侧输卵管破裂处的严重出血，腹腔内出血总量为1946.7 ml，导致了失血性休克。组织病理学检查显示肺水肿以及肾脏和胃的坏死，表明多器官功能衰竭。</p> <p>通过排除其他可能性，确认该猝死病例系自然原因所致。</p></trans-abstract><kwd-group xml:lang="en"><kwd>autopsy</kwd><kwd>cause of death</kwd><kwd>fallopian tubes</kwd><kwd>forensic pathology</kwd><kwd>ectopic pregnancy</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>вскрытие</kwd><kwd>причина смерти</kwd><kwd>фаллопиевы трубы</kwd><kwd>судебно-медицинская экспертиза трупа</kwd><kwd>внематочная беременность</kwd></kwd-group><kwd-group xml:lang="zh"><kwd>尸检</kwd><kwd>死因</kwd><kwd>输卵管</kwd><kwd>法医学尸检</kwd><kwd>异位妊娠</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><citation-alternatives><mixed-citation xml:lang="en">Risgaard B, Lynge TH, Wissenberg M, et al. Risk factors and causes of sudden noncardiac death: A nationwide cohort study in Denmark. Heart Rhythm. 2015;12(5):968–974. doi: 10.1016/j.hrthm.2015.01.024</mixed-citation><mixed-citation xml:lang="ru">Risgaard B., Lynge T.H., Wissenberg M., et al. Risk factors and causes of sudden noncardiac death: A nationwide cohort study in Denmark // Heart Rhythm. 2015. Vol. 12, N 5. P. 968–974. doi: 10.1016/j.hrthm.2015.01.024</mixed-citation><mixed-citation xml:lang="zh">Risgaard B, Lynge TH, Wissenberg M, et al. Risk factors and causes of sudden noncardiac death: A nationwide cohort study in Denmark. Heart Rhythm. 2015;12(5):968–974. doi: 10.1016/j.hrthm.2015.01.024</mixed-citation></citation-alternatives></ref><ref id="B2"><label>2.</label><citation-alternatives><mixed-citation xml:lang="en">Saukko P, Knight B. Knight’s forensic pathology. 4th ed. New York, CRC press, Taylor and Francis Group; 2016. 666 р.</mixed-citation><mixed-citation xml:lang="ru">Saukko P., Knight B. Knight’s forensic pathology. 4th ed. New York, CRC press, Taylor and Francis Group, 2016. 666 р.</mixed-citation><mixed-citation xml:lang="zh">Saukko P, Knight B. Knight’s forensic pathology. 4th ed. New York, CRC press, Taylor and Francis Group; 2016. 666 р.</mixed-citation></citation-alternatives></ref><ref id="B3"><label>3.</label><citation-alternatives><mixed-citation xml:lang="en">Naneix AL, Périer MC, Beganton F, et al. Sudden adult death: An autopsy series of 534 cases with gender and control comparison. J Forensic Leg Med. 2015;32:10–15. doi: 10.1016/j.jflm.2015.02.005</mixed-citation><mixed-citation xml:lang="ru">Naneix A.L., Périer M.C., Beganton F., et al. Sudden adult death: An autopsy series of 534 cases with gender and control comparison // J Forensic Leg Med. 2015. Vol. 32. P. 10–15. doi: 10.1016/j.jflm.2015.02.005</mixed-citation><mixed-citation xml:lang="zh">Naneix AL, Périer MC, Beganton F, et al. Sudden adult death: An autopsy series of 534 cases with gender and control comparison. J Forensic Leg Med. 2015;32:10–15. doi: 10.1016/j.jflm.2015.02.005</mixed-citation></citation-alternatives></ref><ref id="B4"><label>4.</label><citation-alternatives><mixed-citation xml:lang="en">Chukus A, Tirada N, Restrepo R, Reddy NI. Uncommon implantation sites of ectopic pregnancy: Thinking beyond the complex adnexal mass. Radiographics. 2015;35(3):946–959. doi: 10.1148/rg.2015140202</mixed-citation><mixed-citation xml:lang="ru">Chukus A., Tirada N., Restrepo R., Reddy N.I. Uncommon implantation sites of ectopic pregnancy: Thinking beyond the complex adnexal mass // Radiographics. 2015. Vol. 35, N 3. P. 946–959. doi: 10.1148/rg.2015140202</mixed-citation><mixed-citation xml:lang="zh">Chukus A, Tirada N, Restrepo R, Reddy NI. Uncommon implantation sites of ectopic pregnancy: Thinking beyond the complex adnexal mass. Radiographics. 2015;35(3):946–959. doi: 10.1148/rg.2015140202</mixed-citation></citation-alternatives></ref><ref id="B5"><label>5.</label><citation-alternatives><mixed-citation xml:lang="en">Lee R, Dupuis C, Chen B, et al. Diagnosing ectopic pregnancy in the emergency setting. Ultrasonography. 2018;37(1):78–87. doi: 10.14366/USG.17044</mixed-citation><mixed-citation xml:lang="ru">Lee R., Dupuis C., Chen B., et al. Diagnosing ectopic pregnancy in the emergency setting // Ultrasonography. 2018. Vol. 37, N 1. P. 78–87. doi: 10.14366/USG.17044</mixed-citation><mixed-citation xml:lang="zh">Lee R, Dupuis C, Chen B, et al. Diagnosing ectopic pregnancy in the emergency setting. Ultrasonography. 2018;37(1):78–87. doi: 10.14366/USG.17044</mixed-citation></citation-alternatives></ref><ref id="B6"><label>6.</label><citation-alternatives><mixed-citation xml:lang="en">Panelli DM, Phillips CH, Brady PC. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: A review. Fertil Res Pract. 2015;(1):15. doi: 10.1186/s40738-015-0008-z</mixed-citation><mixed-citation xml:lang="ru">Panelli D.M., Phillips C.H., Brady P.C. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: A review // Fertil Res Pract. 2015. Vol. 1. P. 15. doi: 10.1186/s40738-015-0008-z</mixed-citation><mixed-citation xml:lang="zh">Panelli DM, Phillips CH, Brady PC. Incidence, diagnosis and management of tubal and nontubal ectopic pregnancies: A review. Fertil Res Pract. 2015;(1):15. doi: 10.1186/s40738-015-0008-z</mixed-citation></citation-alternatives></ref><ref id="B7"><label>7.</label><citation-alternatives><mixed-citation xml:lang="en">Gaskins AJ, Missmer SA, Rich-Edwards JW, et al. Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. Fertil Steril. 2018;110(7):1328–1337. doi: 10.1016/j.fertnstert.2018.08.022</mixed-citation><mixed-citation xml:lang="ru">Gaskins A.J., Missmer S.A., Rich-Edwards J.W., et al. Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy // Fertil Steril. 2018. Vol. 110, N 7. P. 1328–1337. doi: 10.1016/j.fertnstert.2018.08.022</mixed-citation><mixed-citation xml:lang="zh">Gaskins AJ, Missmer SA, Rich-Edwards JW, et al. Demographic, lifestyle, and reproductive risk factors for ectopic pregnancy. Fertil Steril. 2018;110(7):1328–1337. doi: 10.1016/j.fertnstert.2018.08.022</mixed-citation></citation-alternatives></ref><ref id="B8"><label>8.</label><citation-alternatives><mixed-citation xml:lang="en">Nugraha AR, Sa’adi A, Tirthaningsih NW. Profile study of ectopic pregnancy at Department of Obstetrics and Gynecology, Dr. Soetomo Hospital, Surabaya, Indonesia. Majalah Obstetri &amp; Ginekologi. 2020;28(2):75. doi: 10.20473/mog.v28i22020.75-78</mixed-citation><mixed-citation xml:lang="ru">Nugraha A.R., Sa’adi A., Tirthaningsih N.W. Profile study of ectopic pregnancy at Department of Obstetrics and Gynecology, Dr. Soetomo Hospital, Surabaya, Indonesia // Majalah Obstetri &amp; Ginekologi. 2020. Vol. 28, N 2. P. 75. doi: 10.20473/mog.v28i22020.75-78</mixed-citation><mixed-citation xml:lang="zh">Nugraha AR, Sa’adi A, Tirthaningsih NW. Profile study of ectopic pregnancy at Department of Obstetrics and Gynecology, Dr. Soetomo Hospital, Surabaya, Indonesia. Majalah Obstetri &amp; Ginekologi. 2020;28(2):75. doi: 10.20473/mog.v28i22020.75-78</mixed-citation></citation-alternatives></ref><ref id="B9"><label>9.</label><citation-alternatives><mixed-citation xml:lang="en">Indrayanti S, Dharmayanti HE, Yusuf M. Management of abdominal pregnancy with placenta left in situ. Bali Med J. 2024;13(2):593–597. doi: 10.15562/bmj.v13i2.4927</mixed-citation><mixed-citation xml:lang="ru">Indrayanti S., Dharmayanti H.E., Yusuf M. Management of abdominal pregnancy with placenta left in situ // Bali Med J. 2024. Vol. 13, N 2. P. 593–597. doi: 10.15562/bmj.v13i2.4927</mixed-citation><mixed-citation xml:lang="zh">Indrayanti S, Dharmayanti HE, Yusuf M. Management of abdominal pregnancy with placenta left in situ. Bali Med J. 2024;13(2):593–597. doi: 10.15562/bmj.v13i2.4927</mixed-citation></citation-alternatives></ref><ref id="B10"><label>10.</label><citation-alternatives><mixed-citation xml:lang="en">Mukti AF, Tunjungseto A. Successful management of an unruptured extrauterine pregnancy in a woman with a history of prior miscarriage in Indonesia: A case report. Indonesian Journal of Obstetrics and Gynecology. 2024;12(2):110–114. doi: 10.32771/inajog.v12i2.2111</mixed-citation><mixed-citation xml:lang="ru">Mukti A.F., Tunjungseto A. Successful management of an unruptured extrauterine pregnancy in a woman with a history of prior miscarriage in Indonesia: A case report // Indonesian Journal of Obstetrics and Gynecology. 2024. Vol. 12, N 2. P. 110–114. doi: 10.32771/inajog.v12i2.2111</mixed-citation><mixed-citation xml:lang="zh">Mukti AF, Tunjungseto A. Successful management of an unruptured extrauterine pregnancy in a woman with a history of prior miscarriage in Indonesia: A case report. Indonesian Journal of Obstetrics and Gynecology. 2024;12(2):110–114. doi: 10.32771/inajog.v12i2.2111</mixed-citation></citation-alternatives></ref><ref id="B11"><label>11.</label><citation-alternatives><mixed-citation xml:lang="en">Cunningham FG, Leveno KJ, Bloom SL, et al. Williams obstetric 24/e. McGraw-Hill Education, McGraw-Hill Medical; 2014. 1376 р.</mixed-citation><mixed-citation xml:lang="ru">Cunningham F.G., Leveno K.J., Bloom S.L., et al. Williams obstetric 24/e. McGraw-Hill Education, McGraw-Hill Medical, 2014. 1376 р.</mixed-citation><mixed-citation xml:lang="zh">Cunningham FG, Leveno KJ, Bloom SL, et al. Williams obstetric 24/e. McGraw-Hill Education, McGraw-Hill Medical; 2014. 1376 р.</mixed-citation></citation-alternatives></ref><ref id="B12"><label>12.</label><citation-alternatives><mixed-citation xml:lang="en">Connolly AJ, Finkbeiner WE, Ursell PC, Davis RL. Autopsy pathology: A manual and atlas. 3rd ed. Elsevier Health Sciences; 2016. 400 р.</mixed-citation><mixed-citation xml:lang="ru">Connolly A.J., Finkbeiner W.E., Ursell P.C., Davis R.L. Autopsy pathology: A manual and atlas. 3rd ed. Elsevier Health Sciences, 2016. 400 р.</mixed-citation><mixed-citation xml:lang="zh">Connolly AJ, Finkbeiner WE, Ursell PC, Davis RL. Autopsy pathology: A manual and atlas. 3rd ed. Elsevier Health Sciences; 2016. 400 р.</mixed-citation></citation-alternatives></ref><ref id="B13"><label>13.</label><citation-alternatives><mixed-citation xml:lang="en">Taran FA, Kagan KO, Hübner M, et al. The diagnosis and treatment of ectopic pregnancy. Dtsch Arztebl Int. 2015;112(41):693–704. doi: 10.3238/arztebl.2015.0693</mixed-citation><mixed-citation xml:lang="ru">Taran F.A., Kagan K.O., Hübner M., et al. The diagnosis and treatment of ectopic pregnancy // Dtsch Arztebl Int. 2015. Vol. 112, N 41. P. 693–704. doi: 10.3238/arztebl.2015.0693</mixed-citation><mixed-citation xml:lang="zh">Taran FA, Kagan KO, Hübner M, et al. The diagnosis and treatment of ectopic pregnancy. Dtsch Arztebl Int. 2015;112(41):693–704. doi: 10.3238/arztebl.2015.0693</mixed-citation></citation-alternatives></ref><ref id="B14"><label>14.</label><citation-alternatives><mixed-citation xml:lang="en">Sariroh W, Primariawan RY. Tingginya infeksi chlamydia trachomatis pada kerusakan tuba fallopi wanita infertil. Majalah Obstetri &amp; Ginekologi. 2015;23(2):69–74. doi: 10.20473/mog.v23i2.2092</mixed-citation><mixed-citation xml:lang="ru">Sariroh W., Primariawan R.Y. Tingginya infeksi chlamydia trachomatis pada kerusakan tuba fallopi wanita infertile // Majalah Obstetri &amp; Ginekologi. 2015. Vol. 23, N 2. P. 69–74. doi: 10.20473/mog.v23i2.2092</mixed-citation><mixed-citation xml:lang="zh">Sariroh W, Primariawan RY. Tingginya infeksi chlamydia trachomatis pada kerusakan tuba fallopi wanita infertil. Majalah Obstetri &amp; Ginekologi. 2015;23(2):69–74. doi: 10.20473/mog.v23i2.2092</mixed-citation></citation-alternatives></ref><ref id="B15"><label>15.</label><citation-alternatives><mixed-citation xml:lang="en">Taghavi S, Nassar AK, Askari R. Hypovolemic shock. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.</mixed-citation><mixed-citation xml:lang="ru">Taghavi S., Nassar A.K., Askari R. Hypovolemic shock // StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing, 2023.</mixed-citation><mixed-citation xml:lang="zh">Taghavi S, Nassar AK, Askari R. Hypovolemic shock. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.</mixed-citation></citation-alternatives></ref><ref id="B16"><label>16.</label><citation-alternatives><mixed-citation xml:lang="en">Kennedy H, Haynes SL, Shelton CL. Maternal body weight and estimated circulating blood volume: A review and practical nonlinear approach. Br J Anaesth. 2022;129(5):716–725. doi: 10.1016/j.bja.2022.08.011</mixed-citation><mixed-citation xml:lang="ru">Kennedy H., Haynes S.L., Shelton C.L. Maternal body weight and estimated circulating blood volume: A review and practical nonlinear approach // Br J Anaesth. 2022. Vol. 129, N 5. P. 716–725. doi: 10.1016/j.bja.2022.08.011</mixed-citation><mixed-citation xml:lang="zh">Kennedy H, Haynes SL, Shelton CL. Maternal body weight and estimated circulating blood volume: A review and practical nonlinear approach. Br J Anaesth. 2022;129(5):716–725. doi: 10.1016/j.bja.2022.08.011</mixed-citation></citation-alternatives></ref><ref id="B17"><label>17.</label><citation-alternatives><mixed-citation xml:lang="en">Merrick C. Shock. In: ATLS: Advanced trauma life support. 10th ed. Student course manual. American College of Surgeons; 2018. Р. 48–50.</mixed-citation><mixed-citation xml:lang="ru">Merrick C. Shock // ATLS: Advanced trauma life support. 10th ed. Student course manual. American College of Surgeons, 2018. Р. 48–50</mixed-citation><mixed-citation xml:lang="zh">Merrick C. Shock. In: ATLS: Advanced trauma life support. 10th ed. Student course manual. American College of Surgeons; 2018. Р. 48–50.</mixed-citation></citation-alternatives></ref></ref-list></back></article>
