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Death of a man managed for backache following a fall from a height

Author:

Indira Deepthi Kitulwatte

University of Kelaniya Western, LK
About Indira
I.D.G.Kitulwatte (MBBS, DLM, MD (Forensic Medicine) Professor in Forensic Medicine, Department of Forensic Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka
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Abstract

Introduction When there is a congenital anomaly of the spine mimicking a fracture in a man who had fallen from a height, medical attention is often drawn towards it and other possibilities of backache are under attended. This case illustrates a death of a man managed for fracture of the spine who had ultimately died of an unexpected, under-attended pathology. Case report A 35-year-old previously healthy man had had a fall from a height 15 days prior to death and was admitted to a surgical ward with backache. He was diagnosed to have a fracture of the 12th thoracic and 1st lumbar vertebrae. On the 14th day after the fall he became confused but was not febrile. Condition worsened and he succumbed. Examination of the x-ray spine revealed the “fracture” of the 12th thoracic vertebra. At autopsy there was a defect in the spine with no associated hemorrhage and therefore could be explained as a preexisting condition. There was a subcutaneous and muscle contusion of the right sacral area with no associated bony injuries. The kidneys were enlarged, congested, oedematous with multiple abscesses indicating acute pyelonephritis. Conclusion The back ache of this man and subsequent confusion can be explained from acute pyelonephritis and systemic changes. Trauma from the fall is minor, but since it was associated with a congenital anomaly of the spine, which mimics a wedge fracture, it was misleading and contributed to misdiagnosis of a possible treatable condition.
How to Cite: Kitulwatte, I.D., 2018. Death of a man managed for backache following a fall from a height. Sri Lanka Journal of Forensic Medicine, Science & Law, 9(1), p.None. DOI: http://doi.org/10.4038/sljfmsl.v9i1.7784
Published on 10 Jul 2018.
Peer Reviewed

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