Significant and potentially overlooked causes of unexpected death outside the cardiovascular and central nervous system

Abstract

Most post-mortem examinations in the United Kingdom (UK) are currently performed at the request of the Coroner to differentiate between natural and unnatural causes of death on balance of probabilities. This has curtailed the remit of the practicing pathologist to only include additional investigations where the results of which would directly influence the cause of death given. The current review discusses sudden unexpected causes of death where additional investigations are required to make the correct diagnosis in certain circumstances. It is focused at pathologists working within Coronial systems and on causes of death outside the cardiovascular and central nervous systems. Specifically, we discuss the utility of cultures in sepsis, histology in unexpected tumours and special investigations in pneumothorax, asthma, anaphylaxis, diabetes mellitus, insulin-overdose, acute pancreatitis, acute liver failure and acute kidney injury.