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Macroscopic and histopathological aspects of chemical damage to human tissues depending on the survival time

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Abstract

The ingestion of corrosive substances is a widely treated topic in clinical and forensic practice, as an accidental event or as a consequence of voluntary assumption to commit suicide. However, thorough macroscopic and microscopic surveys focused on the correlation between the ingestion of the substance and different survival times have never been performed. Are the ingestion and the metabolism of the substance within the human tissues still recognizable? How could it be related to death? The study concerns a retrospective analysis on ten cases (two accidental, eight suicides) of lethal ingestion of different types of liquid caustic substances, without instant death and survival times ranging from 12 h to 6 months. For each case, a full autopsy and histological examination of the internal organs were performed. The results showed that the early direct effect of the substances is exerted mainly on the gastrointestinal tract, but as survival time increased, the metabolism of the substance exerted its effects in different target organs. When the cause of death was not directly linkable to the ingestion of the substance (i.e., related to cardiac stress, electrolyte disorders, pneumonia) and macroscopic findings were nonspecific, histological analyses allowed for providing crucial elements towards a link between death and assumption of the substance.

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References

  1. Howell JM (1986) Alkaline ingestions. Ann Emerg Med 15(7):820–825

    Article  CAS  Google Scholar 

  2. Satar S, Topal M, Kozaci N (2004) Ingestion of caustic substances by adults. Am J Ther 11(4):258–261

    Article  Google Scholar 

  3. Arévalo-Silva C, Eliashar R, Wohlgelernter J, Elidan J, Gross M (2006) Ingestion of caustic substances: a 15-year experience. Laryngoscope 116(8):1422–1426

    Article  Google Scholar 

  4. Contini S, Scarpignato C (2013) Caustic injury of the upper gastrointestinal tract: a comprehensive review. World J Gastroenterol 19(25):3918–3930

    Article  Google Scholar 

  5. Park KS (2014) Evaluation and management of caustic injuries from ingestion of Acid or alkaline substances. Clin Endosc 47(4):301–307

    Article  Google Scholar 

  6. Behera C, Rani A, Pradhan M, Dikshit PC (2014) Fatal corrosive attack: a study of 13 cases from central Delhi, India. Am J Forensic Med Pathol 35(2):109–112

    Article  CAS  Google Scholar 

  7. Pavelites JJ, Kemp WL, Barnard JJ, Prahlow JA (2011) Deaths related to chemical burns. Am J Forensic Med Pathol 32(4):387–392

    Article  Google Scholar 

  8. Petković S, Maletin M, Durendić-Brenesel M (2011) Complex suicide: an unusual case with six methods applied. J Forensic Sci 56(5):1368–1372

    Article  Google Scholar 

  9. Vijayanath V, Nagaraja Rao K, Raju GM, Anitha MR (2012) Forensic issues in suicide due to acid ingestion in a case of major depressive disorder. Am J Forensic Med Pathol 33(2):156–158

    Article  CAS  Google Scholar 

  10. Zoja R (2009) Patologia forense della lesività chimica. In: Giusti G. Trattato di patologia forense e scienze affini, ed. Cedam: 447–478

  11. Nuutinen M, Uhari M, Karvali T, Kouvalainen K (1994) Consequences of caustic ingestions in children. Acta Paediatr 83(11):1200–1205

    Article  CAS  Google Scholar 

  12. Elshabrawi M, A-Kader HH (2011) Caustic ingestion in children. Expert Rev Gastroenterol Hepatol 5(5):637–645

    Article  Google Scholar 

  13. Ramasamy K, Gumaste VV (2003) Corrosive ingestion in adults. J Clin Gastroenterol 37(2):119–124

    Article  Google Scholar 

  14. Franke DD, Davis EG, Woods DR, Johnson RK, Miller FB, Franklin GA, Jortani SA (2011) Catastrophic gastrointestinal injury due to battery acid ingestion. J Emerg Med 40(3):276–279

    Article  Google Scholar 

  15. Nakao K, Ro A, Kibayashi K (2014) Evaluation of the morphological changes of gastric mucosa induced by a low concentration of acetic acid using a rat model. J Forensic Legal Med 22:99–106

    Article  Google Scholar 

  16. Mamede RC, De Mello Filho FV (2002) Treatment of caustic ingestion: an analysis of 239 cases. Dis Esophagus 15(3):210–213

    Article  CAS  Google Scholar 

  17. Mamede RC, de Mello Filho FV (2001) Ingestion of caustic substances and its complications. Sao Paulo Med J 119(1):10–15

    Article  CAS  Google Scholar 

  18. Byard RW (2015) Caustic Ingestion-A Forensic Overview. J Forensic Sci Feb 26. doi:10.1111/1556-4029.12741. [Epub ahead of print]

  19. Advenier AS, Dorandeu A, Charlier P, Lorin de la Grandmaison G (2014) Microscopic acute lesions after caustic exposure. Forensic Sci Int 234:57–63

    Article  CAS  Google Scholar 

  20. Ranghino A, Costantini L, Deprado A, Filiberti O, Fontaneto C, Ottone S, Peron M, Ternavasio Cameroni G, Zamponi E, Guida G (2006) A case of acute sodium chlorate self-poisoning successfully treated without conventional therapy. Nephrol Dial Transplant 21(10):2971–2974

    Article  Google Scholar 

  21. Young RJ, Critchley JA, Young KK, Freebairn RC, Reynolds AP, Lolin YI (1996) Fatal acute hepatorenal failure following potassium permanganate ingestion. Hum Exp Toxicol 15(3):259–261

    Article  CAS  Google Scholar 

  22. Saganuwan SA, Ahur VM, Yohanna CA (2008) Acute toxicity studies of potassium permanganate in Swiss albino mice. Niger J Physiol Sci 23(1–2):31–35

    CAS  PubMed  Google Scholar 

  23. Han J, Zhang Z, Yang S, Wang J, Yang X, Tan D (2014) Betanin attenuates paraquat-induced liver toxicity through a mitochondrial pathway. Food Chem Toxicol 70:100–106

    Article  CAS  Google Scholar 

  24. Yu G, Kan B, Jian X, Wang J, Sun J, Song C (2014) A case report of acute severe paraquat poisoning and long-term follow-up. Exp Ther Med 8(1):233–236

    Article  Google Scholar 

  25. Weijian F, Zan L, Suhong H, Hongmei Z, Lei Z, Yanjie Z, Yi C, Ni J (2006) Destructive effect of percutaneous hydrochloric acid injection therapy for liver cancer--a preliminary experimental and clinical study. Gan To Kagaku Ryoho 33(12):1852–1856

    PubMed  Google Scholar 

  26. Bronstein AC, Spyker DA, Cantilena LR Jr, Rumack BH, Dart RC (2011) Annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 29th Annual Report. Clin Toxicol 50(10):911–1164

    Article  Google Scholar 

  27. Kawamoto O, Ishikawa T, Oritani S, Kuramoto Y, Michiue T, Maeda H (2013) Death following the ingestion of detergent: an autopsy case with special regard to the histochemical findings. Forensic Sci Med Pathol 9(2):208–213

    Article  Google Scholar 

  28. Zoja R, Andreola S, Gentile G, Palazzo E, Piga E, Rancati A (2013) Histopathological findings of medico-legal significance in delayed death from ethylene glycol poisoning. Aust J Forensic Sci 45:37–42

    Article  Google Scholar 

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Authors and Affiliations

  1. Sezione di Medicina Legale e delle Assicurazioni – Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 37, Milano, Italy

    Alberto Amadasi, Guendalina Gentile, Alessandra Rancati & Riccardo Zoja

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  1. Alberto Amadasi
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  2. Guendalina Gentile
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  3. Alessandra Rancati
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  4. Riccardo Zoja
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Correspondence to Alberto Amadasi.

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Amadasi, A., Gentile, G., Rancati, A. et al. Macroscopic and histopathological aspects of chemical damage to human tissues depending on the survival time. Int J Legal Med 130, 743–749 (2016). https://doi.org/10.1007/s00414-015-1265-4

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  • DOI: https://doi.org/10.1007/s00414-015-1265-4

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