Coroner's Finding: Mikl, Petr

72y · Male·haemoperitoneum complicating spontaneous perforation of peritoneal varix in the setting of portal hypertension caused by portal vein thrombosis and hepatocellular carcinoma

Petr Mikl, a 72-year-old man held in secure mental health custody, died from haemoperitoneum due to spontaneous perforation of a peritoneal varix secondary to portal hypertension caused by portal vein thrombosis and hepatocellular carcinoma. He had longstanding schizophrenia and was committed to the Wilfred Lopes Centre under a restriction order following violent offences in 2002. The coroner found his medical care for liver disease and hepatocellular carcinoma was of a high standard, following general practice guidelines with appropriate monitoring and investigation. His liver condition progressed from non-alcoholic steatohepatitis (diagnosed 2017) through cirrhosis to acute liver failure in his final week. The coroner found no deficiencies in treatment or care, noting hepatocellular carcinoma is often diagnosed late with limited surgical options. No clinical errors or system failures were identified.