Finding into death of Susan Bourke

49y · Female·Widespread small and large bowel, splenic and hepatic infarction secondary to severe aortic atherosclerosis

Susan Bourke, a 49-year-old woman, died from widespread small and large bowel infarction secondary to severe aortic atherosclerosis causing critical stenosis of the superior mesenteric and coeliac arteries. She presented to the ED with months of abdominal pain, weight loss and diarrhoea, initially suspected to be ulcerative colitis. A CT scan on 26 August identified splenic infarcts but failed to recognize the critical arterial stenosis. Subsequent clinical deterioration led to emergency laparotomy 5 days later, revealing bowel infarction incompatible with life. While the CT scan findings were difficult to diagnose prospectively even for consultant radiologists, critical documentation gaps prevented clear understanding of whether mesenteric ischaemia was adequately considered during initial assessment. Clinicians should maintain complete clinical records of verbal discussions with radiologists and remain alert to mesenteric ischaemia in patients with unexplained abdominal pain, weight loss, and elevated lactate.