Lethal aorto-oesophageal fistula 16 years after aortic prosthetic reconstruction: Delayed rupture as cause of death.

The development of aorto-oesophageal fistula (AOF) is a rare complication following thoracic aortic repair. Mortality is high, in most cases due to fatal haematemesis. The clinical onset is variable, occurring approximately one year after surgery. We report a case of a lethal AOF in a 58-year-old man. He underwent open vascular surgery 16 years prior to his death due to a rupture of the descending thoracic aorta. In the early 2000s, the open vascular approach was replaced by thoracic endovascular aortic repair. As a result of this approach, the number of surgical complications has reduced, with the exception of AOF.

Forensic NMR metabolomics: one more arrow in the quiver.

INTRODUCTION: NMR metabolomics is increasingly used in forensics, due to the possibility of investigating both endogenous metabolic profiles and exogenous molecules that may help to describe metabolic patterns and their modifications associated to specific conditions of forensic interest. OBJECTIVES: The aim of this work was to review the recent literature and depict the information provided by NMR metabolomics. Attention has been devoted to the identification of peculiar metabolic signatures and specific ante-mortem and post-mortem profiles or biomarkers related to different conditions of forensic concern, such as the identification of biological traces, the estimation of the time since death, and the exposure to drugs of abuse. RESULTS AND CONCLUSION: The results of the described studies highlight how forensics can benefit from NMR metabolomics by gaining additional information that may help to shed light in several forensic issues that still deserve to be further elucidated.