Pathology 6020 - Gastrointestinal Pathology - Case 6

Gastrointestinal Pathology - Case 6 - Part 4

Part 1

Part 2

Part 3

A full autopsy was performed.

The abdominal cavity contained a large amount of bloody fluid and clot. The gastric suture line from the antrectomy was intact and there were four shallow punctate mucosal ulcers in the gastric body. No gastric or esophageal varices were present.

The proximal end of the small bowel consisted of an intact duodenal stump. A number of yellow mucosal ulcerations were found at the C-loop of the duodenum; the largest of which was 2.0 cm x 2.0 cm adjacent to the ampulla.

	Duodenal stump with ulcers
	Microscopic exam demonstrated ulcer penetration into the underlying pancreas with focal acute and chronic pancreatitis.
	Ulceration extending to the pancreas
	Scarring around the pancreatic duct

Beyond the third portion of the duodenum, no further ulcers were found, but the mucosa was both thin and hemorrhagic along the entire length of the bowel to the anus. The small and large bowel contained copious amounts of sanguineous fluid and blood clots.

1. What was the cause of death?