Sudden Unexpected Death from Ischemic Colitis Following Post-traumatic Hospitalization: A Case Report

Abstract

Ischemic colitis (IC) is a serious gastrointestinal condition that can be fatal in older adults with multiple health problems. We report the case of an 81-year-old man who developed IC after a long period of hospitalization for multiple traumatic injuries. Factors such as limited mobility, impaired bowel function, advanced age, cardiovascular/metabolic disorders, and side effects of medications collectively increased vulnerability to colonic ischemia. Despite routine monitoring and stable vital signs, the patient’s condition suddenly deteriorated, resulting in death. Autopsy revealed transmural hemorrhagic necrosis of the sigmoid colon and pan-peritonitis, illustrating how IC can progress silently. Clinicians should be aware of gastrointestinal complications in bedridden older patients or those taking drugs that affect bowel movements. From a forensic perspective, this case demonstrates that death may be linked to the downstream effects of trauma rather than to the injuries themselves, emphasizing the importance of careful postmortem examination. Preventive care, close monitoring of bowel function, and early recognition of warning signs are essential for reducing the risk of fatal outcomes in high-risk populations.