In this study, we present two cases of sudden deaths of people with end-stage kidney with arteriovenous fistulas for long-term hemodialysis treatment. This procedure is associated with a number of known complications. While stenosis, thrombosis, and infection are well known, lethal hemorrhage from arteriovenous fistula is much less commonly encountered. Inspection of the bodies at the scene of the death by a medical examiner suggested that the deaths were due to exsanguination. Autopsies revealed visible defects on the front wall of the arteriovenous fistulas. Microscopic examination showed wall necrosis with infiltration of various inflammatory cells. Deaths were due to exsanguination from the ulcerated arteriovenous fistulas in patients with chronic renal failure. Further investigation revealed that complications in the area around the arteriovenous fistulas were known and were being treated until a sudden rupture of the vessels and hemorrhage from the arteriovenous fistulas resulted in the deaths.

Department of Forensic Medicine and Medical Law University Hospital Olomouc Olomouc CZ 779 00 Czech Republic

Department of Forensic Medicine University Hospital Ostrava Ostrava CZ 708 52 Czech Republic

Department of Intensive Medicine and Forensic Studies Ostrava University Ostrava CZ 703 00 Czech Republic

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