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

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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。

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。

通过排除其他可能性，确认该猝死病例系自然原因所致。

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作者简介

Syahroni S. Syahroni

Airlangga University

编辑信件的主要联系方式.
Email: syahronibinmukin19@gmail.com
ORCID iD: 0000-0003-3058-146X

MD

印度尼西亚, Surabaya

Wira Santoso Ongko

Airlangga University

Email: wiraongko@gmail.com
ORCID iD: 0009-0006-1914-3986

MD

印度尼西亚, Surabaya

Ahmad Yudianto

Airlangga University

Email: yudi4n6sby@yahoo.co.id
ORCID iD: 0000-0003-4754-768X

MD, Dr. (Medicine), Professor

印度尼西亚, Surabaya

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2. Fig. 1. Bleeding in the abdominal cavity.

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3. Fig. 2. Enlarged uterus measuring 7×7×6 cm (a, black arrow). A tear is noted in the right fallopian tube (white arrow); b — the uterine cavity to the vagina is opened. The uterine wall is 2 cm thick, and the mucosa of the uterine cavity is thickened and blackish red.

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4. Fig. 3. Photomicrography findings indicating tubal ectopic pregnancy: a — decidua tissue in the uterus (200×), b — extensive corpus luteum in the right ovary (100×), c — chorionic villi in the right fallopian tube (100×).

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5. Fig. 4. Photomicrography findings indicating the occurrence of multipleorgan failure: a — pulmonary edema with dilated blood vessel congestion (100×), b — renal necrosis with dilated blood vessels (100×), c — gastric necrosis accompanied by infiltration of lymphocytes and neutrophils in the lamina propria (100×).

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