Death of a man managed for backache following a fall from a height

This case illustrates a death of a man who had fallen from a height and managed for fracture of spine who had ultimately died of an unexpected, under-attended pathology.

A 35-year-old previously healthy man had a fall from a height and was admitted to a surgical ward with backache. He was diagnosed to have a fracture of the 12th thoracic and 1st lumbar vertebrae. On the 14th day after the fall he became confused but was not febrile. Condition worsened and he succumbed on the 15th day. Examination of the x-ray spine revealed the “fracture” of the 12th thoracic vertebra.

At autopsy a defect in the spine was detected with no associated hemorrhage. There was subcutaneous and muscle contusions of the right sacral area with no associated bony injuries. The kidneys were enlarged, congested, oedematous with multiple abscesses indicating acute pyelonephritis.

It may be concluded that other possibilities of back ache unrelated to trauma need to be considered in persons who fall from heights.