Sudden death due to black esophagus: a case report

Black esophagus, also known as acute esophageal necrosis syndrome, is a rare but often fatal pathology. It can be identified during autopsy examination and should be diagnosed by the forensic examiner via simple macroscopic examination. We report the case of an elderly man who was found dead, presenting with this pathology. A microscopic examination was carried out that confirmed the diagnosis. We consider that all forensic examiners should be made aware of this pathology to make the diagnosis quickly, in turn allowing the deceased to be returned promptly to their loved ones

Accuracy of water-enema multidetector computed tomography (WE-MDCT) in colon cancer staging: a prospective study

Purpose To assess the accuracy of water-enema multidetector computed tomography (WE-MDCT) in extra-rectal colon cancer staging. Materials and methods Fifty-three patients (mean age 70 years) with extra-rectal colon cancer proven by colonoscopy and biopsy were prospectively evaluated by preoperative WE-MDCT. CT scans were both intraluminal (water enema or WE) and intravenous (iodinated) contrast enhanced (CE). All patients underwent surgery. Tumors were classified with the TNM staging system. Noted CT features were: tumor size and location; tumor form and edges; spread to the pericolic fat or neighboring organs; thickening of retroperitoneal fascia; number, size, and enhancement of the peritumoral lymph nodes. Tumors were classified on CT into 3 T-stage groups: T1/T2, T3, and T4. Lymph nodes were classified by their density after injection [positive over 100 Hounsfield units (HU)]. Results Tumor localization to the specific colon segment was correct in all the cases. The agreement between WE-MDCT staging and histopathology staging was good (k = 0.64). An irregular and bowl-shaped aspect of the external edges of tumor provided excellent sensitivity for T3/T4 inclusion (Se 97.7%, NPV 85.7%). Thickening of a fascia or the abdominal wall provided good specificity for T4 stage (Sp 88.1%, NPV 94.9%). Enhancement over 100 HU of at least one peritumoral lymph node was the best criterion of N+ staging (Sp 67.7%, NPV 87.5%). Conclusion WE-MDCT permits good staging of colon cancer based on objective features