Research Article Open Access Study of Gastrointestinal Causes of Death: A 5-Year Autopsy Based Study Sneha R.Adidam 1 , Varindra Rakhar 2 and Chalapathi Rao Adidam Venkata 2* 1 Department of Internal Medicine, Howard University Hospital, Washington DC 2 Laboratory Services, Eric Williams Medical Sciences Complex (EWMSC), Trinidad and Tobago *Corresponding author Chalapathi Rao Adidam Venkata, Laboratory Services, Eric Williams Medical Sciences Complex (EWMSC), Trinidad and Tobago. E-Mail: avcraouwi@gmail.com Received: May 07, 2022; Accepted: May 12, 2022; Published: May 19, 2022 Journal of Gastroenterology & Hepatology Reports Volume 3(2): 1-5 Keywords: Gastrointestinal and Hepatobiliary-Pancreatic Disorders, Cirrhosis, Gastrointestinal Bleeding, Colo-Rectal Carcinoma, Perforation, Peritonitis Introduction Gastrointestinal (GI) disorders including hepatobiliary-pancreatic (HBP) diseases are a cause for signifcant morbidity and mortality [1,2]. Mortality due to nonmalignant GIHBP disorders are often diagnosed but are less studied. Some of these disorders that could cause death include bleeding, ischemia, peritonitis, perforation of a viscus, mechanical disorders, metabolic disorders and infections [3]. Chronic liver disease, particularly alcohol-related, are increasing over the years even in Asian countries and it is an important cause of mortality. It has been ranked ffth according to statistics in the United Kingdom [4,5]. Globally, while pancreatic cancer is most fatal, acute pancreatitis is a common pancreatic disease associated with signifcant morbidity and mortality [6]. The burden of pancreatic disorders is expected to increase over time and people of African descent are more likely to be affected [7,8]. GI cancers, being the second most common, are an important cause of death. Hugar et al mention that limited studies are presented in the literature despite gastrointestinal diseases being an important cause of sudden natural death. Sudden GI death is an unexpected death due to digestive system causes usually found on autopsy [9]. There may be congenital or acquired causes of sudden GI deaths. Some may be more observable than others [10]. GI disorders, although may not be an immediate cause of death, could be a signifcant contributory condition or may be identifed as an incidental fnding. Abdominal pain was the most common symptom followed by diarrhea, vomiting, nausea, constipation and bleeding [11]. Although the worldwide trend is of declining autopsy rate, a signifcant number of autopsies are routinely performed primarily to establish the cause of death at our tertiary health care center and teaching hospital in Trinidad, West Indies [12]. Autopsy is still considered to be a valuable tool in reliably determining the underlying pathology and cause of death. A 5-year autopsy-based study of gastrointestinal causes of death was conducted to evaluate and understand its impact in the practice of medicine. J Gast Hepa Rep, 2022 ISSN: 2754-4931 ABSTRACT Introduction: Gastrointestinal disorders (GI) including hepatobiliary-pancreatic (HBP) diseases are a cause for signifcant morbidity and mortality. Mortality due to nonmalignant disorders are ofen diagnosed but are less studied. Limited autopsy-based studies have been conducted on gastrointestinal causes of death despite gastrointestinal and hepato-biliary-pancreatic diseases being one of the important causes for morbidity and mortality. Autopsy is still considered a valuable tool in reliably determining the underlying pathology and cause of death. Tis study of gastrointestinal causes of death was conducted to evaluate and understand its impact. Methods: Tis is a 5-year retrospective autopsy-based study for the period August 2016 to July 2021. Data was collected from autopsy request forms, patients’ hospital records and autopsy reports, which included age, gender, ethnicity, salient clinical features, key autopsy fndings and the cause of death. Results: During the 5-year period, a total of 3435 autopsies were performed, out of which 294 cases were found to have gastrointestinal-hepato-biliary- pancreatic (GIHBP) disorders as the cause of death, contributing to 8.6%. Tis accounts for the third leading cause of death. Te main causes of death were gastrointestinal bleeding (GIB) (26%), perforation of a viscus organ and peritonitis (23%), hepato-biliary-pancreatic disease (17%), ischemic bowel changes (13.6%), neoplastic disease (11.6%) and others. Majority of patients were males and of African ethnicity. Patients aged above 40 years accounted for 83% of the deaths. Abdominal pain was the most common presenting symptom. Tree leading autopsy fndings include gastrointestinal bleeding, ascites, perforation and peritonitis. Conclusion: GIHBP disorders are the third leading cause of death. GI bleeding, non-traumatic perforation and peritonitis are identifed as signifcant mechanisms of death. Autopsy still plays an important role in reliably determining the cause of death. Prompt diagnosis and appropriate management may decrease mortality. Tis study augments the limited body of literature and provides insight into gastrointestinal causes of death.