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The pulmonary alveolocapillary dysplasia (ACD) with pulmonary vein misalignment (PVM) is a rare condition characterized by a congenital anomaly of the development of the pulmonary parenchyma. We present a case of an 8-month-old infant who died quickly from acute respiratory failure complicating an unknown ACD. We also describe its epidemiological characteristics in infants and we discuss the diagnosis's difficulties. In this case, a pulmonary arterial hypertension was decompensated by an infection. A medico-legal autopsy was performed. As for the Histological examination, it showed the features of ACD/PVM.

We describe, the clinical presentation of a rare case of Tracheal Agenesis in a preterm infant and we highlight magnetic imaging resonance (MRI) and autopsy findings to better characterize this anomaly. A 30-year-old female presented for acute polyhydramnios at 30 weeks gestation of a male foetus. Prenatal MRI was performed and excluded this diagnosis. After delivery, the neonate presented a respiratory distress. The laryngoscopy control of tube position concluded to an esophageal intubation. A second reading of antenatal MRI was made. An autopsy was performed. The internal examination of the organs revealed broncho-oesophageal fistula. The upper airways were obstructed at the larynx. Fetal MRI should be interpreted with caution when Tracheal Agenesis is highly suspected.

Resume La mort subite a un âge jeune est vecue comme un phenomene dramatique necessitant la connaissance de son incidence. Notre etude a pour objectifs de decrire les particularites epidemiologiques de la mort subite cardiaque d’origine ischemique chez le sujet jeune dans la population d’etude et de discuter son implication dans la survenue du deces. Dans ce travail, le sujet jeune a ete defini comme toute personne âgee de 1 an a 35 ans pour les sujets de sexe masculin, et jusqu’a 45 ans pour les sujets de sexe feminin. Il s’agit d’une etude descriptive, retrospective, exhaustive, concernant 312 cas de mort subite chez le sujet jeune colliges au service de medecine legale de l’hopital universitaire Fattouma Bourguiba de Monastir-Tunisie, durant une periode de 23 ans. Les donnees recueillies ont ete saisies et traitees a l’aide du logiciel SPSS 20. Le taux de significativite a ete fixe a 0,05. Trente-deux cas de mort subite cardiaque d’origine ischemique ont ete recenses. L’infarctus du myocarde (IDM) representait la deuxieme cause de mort subite du sujet jeune apres la cardiomyopathie hypertrophique. La predominance masculine etait nette. La tranche d’âge la plus touchee etait celle entre 25–45 ans. La mortalite par IDM est survenue plus frequemment au repos. Une coronaropathie a ete objectivee dans vingt-quatre cas (75 %). L’IDM est survenu sur des arteres coronaires saines dans huit cas. Une anomalie du trajet, en particulier le pont myocardique, a ete trouvee dans huit cas (25 %). Le « screening » toxicologique etait negatif dans tous les cas. La prevention doit interesser toute la population avec une education sur les moyens des mesures generales d’hygiene de vie et de prevention des facteurs de risques cardiovasculaires a long terme, ainsi que le depistage clinique oriente au moindre signe d’appel.

The discovery of a hydatid cyst at autopsy poses the problem of its involvement in the mechanism of death. The aim of this study is to analyse the epidemiological and etiopathogenic characteristics of death attributed to hydatid disease, to discuss the mechanism of death and to propose preventive measures. This is a retrospective descriptive study of 26 cases of death with hydatid cyst autopsic discovered, collected at the forensic department of Fattouma Bourguiba University Hospital of Monastir (Tunisia) over a period of 27 years (from 1990 until 2017). In 26 cases, hydatid cyst was observed during autopsy of sudden death cases, which corresponds to 0.33% of the total of autopsies in this period. Of the 26 victims, 13 (50%) were men; the mean age was 43 years. Most victims were from rural zones (18 cases). In 20 cases, the complicated cyst was hepatic. It was cardiac in two cases. Of all cases, three cysts were cracked, and nine were broken. Of the 26 cases, only 15 were implicated in the death mechanism. Death was attributed to anaphylaxis in 12 cases, hydatid pulmonary embolism in 1 case, cardiac arythmia in one case and hemothorax in one case. Sudden death is the most dangerous complication of the hydatid cyst which can be discovered at autopsy. Several causes may explain its occurrence, the most common of which is anaphylactic shock.

Background We aim to study the profile, and pathological characteristics of sudden death in young in purpose of recommendations for prevention. Methods We performed a retrospective cohort study using autopsy data from the Department of Forensic Medicine of Monastir (Tunisia). A review of all autopsies performed for 28 years was done (August 1990 to December 2018). In each case, clinical information, and circumstances of death were obtained. A complete forensic autopsy and histological, and toxicological investigations were performed. We have included all sudden death in persons aged between 18 and 35 years. Results We collected 137 cases of sudden death during the studied period. The mean age of the studied population was 26.47 years. Almost 72% deaths were classified as cardiac death, and was due to ischemic heart disease in 32.32%. Sudden death was attributed to a pleuropulmonary cause in 7.4%, an abdominal cause in 6%, and from a neurological origin in 4.5%. The cause of sudden death in this group was not established by 9.5%. Conclusion In this series, sudden death in young adults occurs mainly in a smoking male, aged between 18 and 24 years old, occurring at rest, in the morning, and early in the week. It is more common, especially in summer. Sudden death is most often the first manifestation of pathologies, especially unsuspected heart diseases. The predominance of cardiovascular causes is the common denominator of almost all studies reported in the literature. Our findings suggest that prevention of sudden death among young adults under the age of 35 years should also focus on evaluation for causes not associated with structural heart disease.

We aim to establish a Tunisian score for age estimation through the study of chest plate’s radiographs of a Tunisian male sample. We have focused on the study of 128 chest plate radiographs of Tunisian male individuals. We have established a score of eight criteria. The total score ranges from 8 to 32. Three observers scored double-blind the X-ray films. We studied the correlation of each criterion as well as the total score with chronological age for each observer. We also tested the reproducibility and the repeatability of criteria and total score. We calculated the estimated age for each score. We studied the relationship between the estimated age and the chronological age. The correlation between the total score and the chronological age has been good for the three observers (0.746, 0.756 and 0.742). The total score gives an estimation of age with a standard deviation of ± 5.88 years and a confidence interval of 95%, the interval’s width increases gradually from 6.9 years to 23 years.