Table III Comparison of provisional and post-mortem diagnoses

 

Age Sex

Presentation

Provisional Diagnosis

Post-mortem Diagnosis

70

F

 

Abdominal pains, diffuse abdominal tenderness,

pale, hypotensive.

Aortic aneurysm Acute GI haemorrhage due to     mesenteric ischaemia

70

1

found collapsed and ambulance called   Peptic ulcer-perforated

73

F

Haematemesis  

Cardiac arrest;

bleeding oesophageal varices

Acute GI haemorrhage due to aorto-jejunal fistula

70

M

Chest pains, anorexia  

“Not heart related”

 

Acute GI haemorrhage due to peptic ulcer

81

M

Found collapsed, dehydrated, rigid abdomen Infarcted bowel  

Acute GI haemorrhage due to peptic ulcer

73

F

Abdominal pains, shocked, cold, confused Peritonitis  

Peptic ulcer-perforated

70

1

    Acute GI haemorrhage-Peptic ulcer

70

1

sick several times; slurred and incoherent speech   Peptic ulcer-perforated

71

1

shaking and rocking in his chair   Acute GI haemorrhage

71

2

nausea, vomit, flu-like   Peptic ulcer-perforated

71

1

passed blood', unwell, coughed up bld; pt said would take a lift fr a friend to the surgery   Acute GI haemorrhage-Peptic ulcer

81

F

Nausea & abdominal discomfort;

collapsed with hypotension and high pulse

 

Postoperative pulmonary embolism or a major cardiac event

 

Peptic ulcer-perforated

71

F

 

Vomited, feverish, abdominal discomfort,

jaw pain, breathless, peripheral cyanosis,

slight tenderness in abdomen

Pulmonary oedema Colon-perforated diverticulum

74

M

 

Abdominal pains

Constipation Colon-perforated diverticulum

73

1

    Acute GI haemorrhage

73

1

    Pancreas-Acute pancreatitis

73

2

unwell, sore back, SOB   Peptic ulcer-perforated

73

1

unwell, sickness, pins and needles   Acute GI haemorrhage-Peptic ulcer

75

F

 

Stomach pains; vaginal discharge

Vaginal fistula Colon-perforated diverticulum

79

M

 

Urinary frequency, lower abdominal pain,

distended bladder

 

Urinary retention

Colon-perforated diverticulum

76

2

unwell, vomited few times for 2/7   Acute intestinal obstruction

74

1

    Pancreas-carcinoma

74

1

    Acute GI haemorrhage-Peptic ulcer

74

2

stomach pains(1/7), constipation massive stomach haemorrhage Peptic ulcer-perforated

75

2

found unconscious   Acute cholecystitis

77

1

abdo pains, vomited   Acute intestinal obstruction

79

F

 

Abdominal pains, constipation, nausea,

distended, tender abdomen but no guarding

Constipation Colon-perforated diverticulum

85

F

 

Abdominal pains, fullness in left side of abdomen,

extremely unwell

Mesenteric Ischaemia Colon-perforated diverticulum

79

F

 

Sudden onset of generalised abdominal pain,

no motions but passing flatus, guarding, pyrexial

Peritonitis, septicaemia, cardiac failure Perforated colon due to ischaemia

75

M

Weight loss, gaunt, listless  

Diarrhoea due to antibiotics for an UTI;

malnourished

Perforated colon due to carcinoma

75

1

c/o stomach upset 2/7 ago to friends   Acute Intestinal obstruction

75

1

abdo swelling (2/12) due to enlarged liver spread of ca fr an area of the bowel (after scan) Pancreas-carcinoma

75

2

    Acute GI haemorrhage-Peptic ulcer

75

2

    Colon-perforated diverticulum

76

1

collapsed and SOB   Acute GI haemorrhage

76

1

abdo pains, vomiting; abdo pain   Acute intestinal obstruction

Age Sex

Presentation

Provisional Diagnosis

Post-mortem Diagnosis

83

F

Stomach pain, “very ill” Intra-abdominal perforation  

Perforated colon due to stercoral ulceration

79

1

confused, deteriorating health over past month   Acute UTI

79

2

violently sick, severe stomach pain   Peptic ulcer-perforated

76

1

    Acute GI haemorrhage-Peptic ulcer

76

1

    Peptic ulcer-perforated

76

2

    Mesenteric ischaemia

79

1

Pains in sides   Peptic ulcer-perforated

77

1

    Acute cholecystitis

77

2

    Acute UTI

89

F

Dizzy UTI  

Perforated colon due to stercoral ulceration

81

2

found in a collapsed, incontinent state   Colon-perforated diverticulum

82

1

bouts of severe diarrhoea (given laxative the previous night); later pale and clammy;o/e respond to pain   Mesenteric ischaemia

82

1

malaena   Acute GI haemorrhage

83

1

V&D, abdo pains, anorexia; persisted; chest pain   Others

78

1

    Acute GI haemorrhage-Peptic ulcer

78

1

    Mesenteric ischaemia

78

2

unwell the day b4   Others

78

2

    Acute GI haemorrhage-Peptic ulcer

78

2

    Pancreas-carcinoma

78

2

constipation 8/52; SOB and collapse   Colon-perforation

79

2

felt ill, found in a kneeling position on the floor with head btwbed & bedside unit   Acute GI haemorrhage

74

F

Poor colour, cold, clammy, nauseous, anorexia Infection  

Mesenteric ischaemia

86

1

tenderness in lower abdo, vomiting (11/7 )   Acute intestinal obstruction

87

2

stomach pain, blood in stools   Acute GI haemorrhage

87

1

malaena; faint; and malaena   Acute GI haemorrhage-Peptic ulcer

87

F

Unwell; shock Mesenteric infarction  

Mesenteric ischaemia

88

2

Abdo pains, unwell; later BP 96/60, P60   Peptic ulcer-perforated

79

1

feeling sore all over, holding his head; mouth twitching, SOB   Pancreas-Acute pancreatitis

80

1

seemed very chesty   Mesenteric ischaemia

80

2

    Acute UTI

92

F

Sore stomach, sickness Gastroenteritis  

Mesenteric ischaemia

89

1

Pale, shaky, abdo pains, refused solid food; later abdo pains, conc urine   Acute UTI

82

1

    Colon-perforated diverticulum

82

2

    Pancreas-Acute pancreatitis

82

2

    Acute UTI

93

1

diarrhoea and fall, sick and loose stools   Acute GI haemorrhage-Peptic ulcer

93

2

agitated, distressed X2; feverish,hyperventilating, cold L leg; pulseless   Mesenteric ischaemia

70

2

chest and abdo pains   Mesenteric ischaemia

83

2

found covered in blood the day b4 by daughter, died the next day   Acute GI haemorrhage-Peptic ulcer

74

2

vomiting & diarrhoea   Acute UTI

84

1

    Acute UTI

84

2

    Acute cholecystitis

84

2

    Peptic ulcer-perforated

85

2

found collapsed at home and sent to hos, then arrested   Acute UTI

75

2

haematemesis, malaena   Acute GI haemorrhage-Peptic ulcer

86

2

    Acute UTI

86

2

    Pancreas-Acute pancreatitis

76

M

Tonic clonic seizures;  

hypotensive, distended abdomen

Usual seizure for the patient (known chronic epileptic)  

Acute intestinal obstruction due to diaphragmatic hernia

78

1

Haematemesis, pain epigastric->chest->jaw   Acute GI haemorrhage

78

2

while in REH, weight loss, over months; vomiting, high temp, pulse, distended abdo (but pt insisted fine)   Acute intestinal obstruction

78

2

unable to get out of bed, fall with Lsided weakness, hypoglycaemic; normal abdomen! Dehydrated, low BP, confused   Mesenteric ischaemia

89

M

Abdominal pains, distended abdomen Urinary retention  

Acute intestinal obstruction due to ileal volvulus

83

M

Abdominal distention and vomiting Intestinal obstruction  

Acute Intestinal obstruction due to caecal carcinoma

83

1

L abdo pains; CXR:old pneumothorax   Peptic ulcer-perforated

83

2

admitted for CREST and ischaemic foot   Mesenteric ischaemia

84

1

burns in hot bath & semiconscious; hos: dev rectal bleeding   Acute GI haemorrhage

89

2

SOB, v. frail,   Acute UTI

73

F

Unwell, sickness, back pain “Nothing wrong found, hence no treatment”  

Acute UTI

72

2

when arrived no responsive or CO   Colon-perforated diverticulum

72

1

laboured breathing   Acute UTI

72

2

under the weather   Colon-perforated diverticulum

72

2

unwell(days)   Acute UTI

73

2

discovered by daughter and son-in-law and conveyed to A&E   Acute UTI

92

F

 

Unresponsive, refused to drink;

swollen legs; hypoglycaemia

Cerebrovascular accident

Diabetes Mellitus

Acute UTI

90

2

semi-conscious and neighbour called doc, when doc arrived, pt up and about and refused to be examined; died later   Peptic ulcer-perforated

77

F

 

“Chesty”

Exacerbation of COPD Acute pancreatitis

87

F

 

Abdominal pains, vomited blood;

drowsy, cold, peripherally shut down, tender abdomen,     markedly raised amylase

Pancreatitis Acute pancreatitis

78

F

 

Diarrhoea, anorexia, low urine output for days

Diarrhoea due to antibiotics Pseudomembranous colitis

 

 

(Diagnoses in bold º diagnosis confirmed at autopsy)