Case Study: Disseminated Intravascular Coagulation at Autopsy of a Child with Severe Burns Resulting in Death

Muhammad Yusuf Arrozhi*  -  Ahmad Dahlan University, Indonesia

(*) Corresponding Author
Childhood is a time of growth and development, both intellectually and emotionally. The Indonesian Child Protection Commission has observed a growing number of cases of violence against children, including physical and verbal abuse, which require special attention and handling. Physical violence can include burns, which are particularly dangerous in developing countries, where the mortality rate is high. Severe burns can result in inhalation injury and sepsis, which can cause coagulation disorders, making it easier for Disseminated Intravascular Coagulation (DIC) to occur. This study aims to describe the coagulation function of severely burnt patients, investigate the potential causes of DIC, and examine other clinical data. The study used a case study approach, analyzing the corpse of a child who suffered from severe burns. An autopsy was performed and supporting examinations were conducted to determine the cause of death. The examination of the patient's laboratory results, treatment records, corpse, and anatomical pathology revealed the presence of DIC. The autopsy of the child's corpse showed severe burns, pale coloring in the tissues under the nails, and blood clots in the epidural, left ventricle, right ventricle, and veins. The cause of death was determined to be severe burns causing multiple organ dysfunction.

Keywords: disseminated intravascular; coagulation: forensic autopsy; burns in corpses

  1. DiMaio, V.J.M. & Molina, K.D. (2021). DiMaio’s forensic pathology. (3rd edition). New York, CRC Press. doi:10.4324/9780429318764.
  2. Hettiaratchy, S. & Dziewulski, P. (2004). ABC of burns introduction. BMJ. Vol: 328. Page: 1366–1368. Available from: doi: 10.1136/bmj.328.7452.1366. PMID: 15178618.
  3. Mitra, B., Wasiak, J., Cameron, P.A., O’Reilly, G., et al. (2013). Early coagulopathy of major burns. Injury. Vol: 44 (1). doi:10.1016/j.injury.2012.05.010.
  4. Moore, R.A., Waheed, A. & Burns, B. (2022). Rule of nines. Available from: PMID: 30020659
  5. Saukko, P. & Knight, B. (2016). Forensic Pathology 4th ed. (4th edition). New York, CRC Press. ISBN: 13:978-1-4441-6508-1
  6. Setiawan, D. (2015). KPAI: Pelaku Kekerasan Terhadap Anak Tiap Tahun Meningkat. Komisi Perlindungan Anak Indonesia. Available from:
  7. Takemitsu, T., Wada, H., Hatada, T., Ohmori, Y., et al. (2011). Prospective evaluation of three different diagnostic criteria for disseminated intravascular coagulation. Thrombosis and Haemostasis. Vol: 105 (1). doi:10.1160/TH10-05-0293.
  8. Taylor Jr., F.B., Toh, C.-H., Hooth W. Keith, Wada, H., et al. (2001). Scientific and standardization committee communications: towards a definition, clinical and laboratory criteria, and a scoring system for disseminated intravascular coagulation. ISTH Website. PMID: 11816725
  9. Thachil, J. (2016). Disseminated intravascular coagulation: a practical approach. Anesthesiology. Vol: 125 (1). doi:10.1097/ALN.0000000000001123.
  10. Wada, H., Thachil, J., di Nisio, M., Kurosawa, S., et al. (2013). Harmonized guidance for disseminated intravascular coagulation from the international society on thrombosis and hemostasis and the current status of anticoagulant therapy in japan: a rebuttal. Journal of International Society on Thrombosis and Haemostasis. Vol: 11 (11), page: 2078–2079. doi:10.1111/jth.12366.
  11. Wiegele, M., Schaden, E., Koch, S., Bauer, D., et al. (2019). Thrombin generation in patients with severe thermal injury. Burns. Vol: 45 (1). doi:10.1016/j.burns.2018.09.020.
  12. Woodside, A.G. (2017). Case study research: core skill sets in using 15 genres. Emerald Group Publishing Limited. ISSN: 0289-6001.
  13. Zhang, L., Labib, A.M. & Hughes, P.G. (2022). Escharotomy. Available from: PMID: 29489153.
  14. Zhang, T. Ning, Ba, T., Li, F., Chen, Q., et al. (2022). Coagulation dysfunction of severe burn patients: a potential cause of death. Elsevier-Burns Journal. doi:10.1016/j.burns.2022.05.003.

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ISSN: 2339-093X (Online) | 2085-1545 (Print)
DOI : 10.30659/sainsmed

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