Ganesh Rajahan Associate Professor, Department of Forensic Medicine and Toxicology, SRMC & RI, Chennai, Tamil Nadu, India
Syed Affridh Final year Postgraduate, Department of Forensic Medicine and Toxicology, SRMC & RI, Chennai, Tamil Nadu, India
Venkatesan. M. Department of Forensic Medicine and Toxicology, SRMC & RI, Chennai, Tamil Nadu, India
Sneha S. Associate Professor, Department of Forensic Medicine and Toxicology, SRMC & RI, Chennai, Tamil Nadu, India
Priyadarshee Pradhan Professor and Head, Department of Forensic Medicine and Toxicology, SRMC & RI, Chennai, Tamil Nadu, India
Address for correspondence: Ganesh Rajahan, Associate Professor, Department of Forensic Medicine and Toxicology, SRMC & RI, Chennai, Tamil Nadu, India E-mail: drganesh2908@gmail.com
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Syed Affridh, Ganesh Rajahan, Venkatesan M. et al. Sudden Death: The Unseen Danger of Tuberculosis. Indian J Forensic Med Pathol. 2026; 19(3): 381-384
Timeline
Received : March 17, 2026
Accepted : May 26, 2026
Published : September 30, 2026
Abstract
Tuberculosis still remains a major global health problem, especially in developing countries. Death and prevalence of tuberculosis have been reported worldwide. Tuberculosis usually presents primarily as lung disease with dissemination to the intestines increasing its morbidity. But the challenging part is its vague symptoms. Sudden death following intestinal TB is rare. A case involving a 24-year-old woman was received in unconscious state at the emergency department with complaints of severe stomach pain and vomiting. Despite resuscitative measures, she was declared dead. The postmortem examination revealed a white, cheeselike area at the apex of her right lung. Thickened dark tissue noted over the ileocecal junction. Histopathology confirmed tuberculosis in both lungs and intestines. Intestinal obstruction was noted at the site of TB involvement. This case highlights the importance of recognizing severe forms of intestinal tuberculosis this case underlines the vital role of precise medicolegal autopsy and complete histopathological examination in identifying hidden causes of sudden death.
References
1. World Health Organization. Tuberculosis. WHO, 2024.
2. Stat Pearls Publishing. Digestive Tract Tuberculosis.
3. Horvath K.D., Whelan R.L. Intestinal tuberculos is: return of an old disease. Am J Gastroenterol. 1998; 93: 692–696.
4. Sharma S.K., Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004.
5. Ma J.Y., et al. Intestinal tuberculosis and Crohn’s disease: diagnostic challenges. World J Gastroenterol. 2016; 22: 155–161.
6. Ha H.K., et al. Abdominal tuberculosis: radiologic features and differential diagnosis. Radio graphics. 1999; 19: 32–38.
7. Weedon D. Granulomasinderma to pathology. Dermatopathology. 2021.
8. Na J.Y., et al. Suddenun expected death caused by intestinal tuberculosis. Medicine (Baltimore). 2015.
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.
This license enables
reusers to distribute, remix, adapt, and build upon the material in any medium
or format for noncommercial purposes only, and only so long as attribution is
given to the creator.
Description: Gross specimen reveals a white cheesy area with hemorrhage present over the apex of the right lung
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Description: Gross dissected specimen reveals blackish discoloration and concentric thickening of the ileocecal wall
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Description: Shows a circumferential ulcer, which is an open sore that goes around the bowel wall in the terminal ileum, the last part of the small intestine. This ulcer narrows the lumen, or interior passage, creating the typical “napkin-ring” stricture, a ring-shaped narrowing that looks like a napkin ring
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Description: Shows a microscopic image stained with Hematoxylin and Eosin (H&E) at 40× and 100×magnification. It reveals epithelioid granulomas. These are clusters of immune cells. The image also displays central caseous necrosis. This means dead tissue with a cheese-like center