FATAL HEMORRHAGE FROM ARTERIOVENOUS DIALYSIS ACCESS SITE: A CASE REPORT

Introduction: Surgical arteriovenous fistula is necessary to hemodialysis in order to have a continuous access to circulation. Complications related to a vascular access are aneurysms, vascular steal syndrome, venous hypertension, bleeding, infections and neurological disorders. The breakthrough bleeding of the fistula is a rare, but fatal, complication Case presentation: The Authors describe the case of a 53-year-old woman, suffering from cronic kidney disease (stage 5) with lateral arteriovenous fistula between the brachial artery and the median basilic vein, died after hemorrhage for rupture of the fistu- la. Autopsy revealed traumatic mechanism as genesis of fatal bleeding. Conclusion: In case of fatal breakthrough bleeding of the fistula the forensic pathologist has to determine whether it is accidental event or otherwise to assess eventually liability in determining death.