Abstract| Volume 52, SUPPLEMENT 1, S102-S103, February 2020

Wischnewsky lesions in a morbidly obese man with cirrhosis, liver failure and cardiomegaly: can this be hypothermia?

      Obesity is an increasingly prevalent co-morbidity that is associated with sudden unexpected death and is commonly encountered in post mortem practice. Due to the effects of increased body-habitus it is, however, uncommon to encounter a death in an obese individual from hypothermia, especially during non-winter seasons. This case documents a hypothermic death in a setting of morbid obesity and subsequent liver failure and cardiomegaly where widespread Wischnewsky lesions and slightly elevated beta-hydroxybutyrate were noted, with non-elevated blood sugar levels. In this rare case, the only identifiable predisposing factor to hypothermia was metabolic derangement resulting in altered energy metabolism.