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Erschienen in: Forensic Science, Medicine and Pathology 3/2016

18.07.2016 | Case Report

Postmortem computed tomography and magnetic resonance imaging facilitates forensic autopsy in a fatal case of poisoning with formic acid, diphenhydramine, and ethanol

verfasst von: Florian Berger, Andrea E. Steuer, Katharina Rentsch, Dominic Gascho, Stamatios Stamou, Sarah Schärli, Michael J. Thali, Thomas Krämer, Patricia M. Flach

Erschienen in: Forensic Science, Medicine and Pathology | Ausgabe 3/2016

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Abstract

A case of fatal poisoning by ingesting formic acid, diphenhydramine, and ethanol by a 25-year-old woman who committed suicide is presented. Prior to autopsy, postmortem computed tomography and postmortem magnetic resonance tomography were performed and revealed severe damage to the stomach, the left thoracic wall, and parts of the liver. Imaging detected acid-induced fluid–fluid level within the thoracic cavity (fat-equivalent fluid and necrotic pleural effusion). This case report illustrates that postmortem cross-sectional imaging may facilitate dissection of severely damaged or complex regions, and may provide additional information compared to autopsy and toxicological examinations alone.
Literatur
1.
Zurück zum Zitat Westphal F, Rochholz G, Ritz-Timme S, Bilzer N, Schütz HW, Kaatsch HJ. Fatal intoxication with a decalcifying agent containing formic acid. Int J Legal Med. 2001;114:181–5.CrossRefPubMed Westphal F, Rochholz G, Ritz-Timme S, Bilzer N, Schütz HW, Kaatsch HJ. Fatal intoxication with a decalcifying agent containing formic acid. Int J Legal Med. 2001;114:181–5.CrossRefPubMed
2.
Zurück zum Zitat Naik RB, Stephens WP, Wilson DJ, Walker A, Lee HA. Ingestion of formic acid-containing agents: report of three fatal cases. Postgrad Med J. 1980;56:451–6.CrossRefPubMedPubMedCentral Naik RB, Stephens WP, Wilson DJ, Walker A, Lee HA. Ingestion of formic acid-containing agents: report of three fatal cases. Postgrad Med J. 1980;56:451–6.CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Dalus D, Mathew AJ, Somarajan Pillai S. Formic acid poisoning in a tertiary care center in South India: a 2-year retrospective analysis of clinical profile and predictors of mortality. J Emerg Med. 2013;44:373–80.CrossRefPubMed Dalus D, Mathew AJ, Somarajan Pillai S. Formic acid poisoning in a tertiary care center in South India: a 2-year retrospective analysis of clinical profile and predictors of mortality. J Emerg Med. 2013;44:373–80.CrossRefPubMed
6.
Zurück zum Zitat Flach PM, Gascho D, Schweitzer W, Ruder TD, Berger N, Ross SG, et al. Imaging in forensic radiology: an illustrated guide for postmortem computed tomography technique and protocols. Forensic Sci Med Pathol. 2014;10:583–606.CrossRefPubMed Flach PM, Gascho D, Schweitzer W, Ruder TD, Berger N, Ross SG, et al. Imaging in forensic radiology: an illustrated guide for postmortem computed tomography technique and protocols. Forensic Sci Med Pathol. 2014;10:583–606.CrossRefPubMed
7.
Zurück zum Zitat Dresen S, Ferreirós N, Gnann H, Zimmermann R, Weinmann W. Detection and identification of 700 drugs by multi-target screening with a 3200 Q TRAP® LC-MS/MS system and library searching. Anal Bioanal Chem. 2010;396:2425–34.CrossRefPubMed Dresen S, Ferreirós N, Gnann H, Zimmermann R, Weinmann W. Detection and identification of 700 drugs by multi-target screening with a 3200 Q TRAP® LC-MS/MS system and library searching. Anal Bioanal Chem. 2010;396:2425–34.CrossRefPubMed
8.
Zurück zum Zitat Berger N, Ampanozi G, Schweitzer W, Ross SG, Gascho D, Ruder TD, et al. Racking the brain: detection of cerebral edema on postmortem computed tomography compared with forensic autopsy. Eur J Radiol. 2015;84:643–51.CrossRefPubMed Berger N, Ampanozi G, Schweitzer W, Ross SG, Gascho D, Ruder TD, et al. Racking the brain: detection of cerebral edema on postmortem computed tomography compared with forensic autopsy. Eur J Radiol. 2015;84:643–51.CrossRefPubMed
9.
Zurück zum Zitat Poley J-W, Steyerberg EW, Kuipers EJ, Dees J, Hartmans R, Tilanus HW, et al. Ingestion of acid and alkaline agents: outcome and prognostic value of early upper endoscopy. Gastrointest Endosc. 2004;60:372–7.CrossRefPubMed Poley J-W, Steyerberg EW, Kuipers EJ, Dees J, Hartmans R, Tilanus HW, et al. Ingestion of acid and alkaline agents: outcome and prognostic value of early upper endoscopy. Gastrointest Endosc. 2004;60:372–7.CrossRefPubMed
10.
11.
Zurück zum Zitat Hantson P, Haufroid V, Wallemacq P. Formate kinetics in methanol poisoning. Hum Exp Toxicol. 2005;24:55–9.CrossRefPubMed Hantson P, Haufroid V, Wallemacq P. Formate kinetics in methanol poisoning. Hum Exp Toxicol. 2005;24:55–9.CrossRefPubMed
12.
Zurück zum Zitat Jones GR, Singer PP, Rittenbach K. The relationship of methanol and formate concentrations in fatalities where methanol is detected. J Forensic Sci. 2007;52:1376–82.PubMed Jones GR, Singer PP, Rittenbach K. The relationship of methanol and formate concentrations in fatalities where methanol is detected. J Forensic Sci. 2007;52:1376–82.PubMed
13.
Zurück zum Zitat Viinamäki J, Rasanen I, Vuori E, Ojanperä I. Elevated formic acid concentrations in putrefied post-mortem blood and urine samples. Forensic Sci Int. 2011;208:42–6.CrossRefPubMed Viinamäki J, Rasanen I, Vuori E, Ojanperä I. Elevated formic acid concentrations in putrefied post-mortem blood and urine samples. Forensic Sci Int. 2011;208:42–6.CrossRefPubMed
14.
Zurück zum Zitat Flach PM, Thali MJ, Germerott T. Times have changed! Forensic radiology—a new challenge for radiology and forensic pathology. AJR Am J Roentgenol. 2014;202:W325–34.CrossRefPubMed Flach PM, Thali MJ, Germerott T. Times have changed! Forensic radiology—a new challenge for radiology and forensic pathology. AJR Am J Roentgenol. 2014;202:W325–34.CrossRefPubMed
15.
Zurück zum Zitat Franckenberg S, Flach PM, Gascho D, Thali MJ, Ross SG. Postmortem computed tomography–angiography (PMCTA) in decomposed bodies: a feasibility study. J Forensic Radiol Imaging. 2015;3:226–34.CrossRef Franckenberg S, Flach PM, Gascho D, Thali MJ, Ross SG. Postmortem computed tomography–angiography (PMCTA) in decomposed bodies: a feasibility study. J Forensic Radiol Imaging. 2015;3:226–34.CrossRef
16.
Zurück zum Zitat Fein G, Meyerhoff DJ. Ethanol in human brain by magnetic resonance spectroscopy: correlation with blood and breath levels, relaxation, and magnetization transfer. Alcohol Clin Exp Res. 2000;24:1227–35.CrossRefPubMedPubMedCentral Fein G, Meyerhoff DJ. Ethanol in human brain by magnetic resonance spectroscopy: correlation with blood and breath levels, relaxation, and magnetization transfer. Alcohol Clin Exp Res. 2000;24:1227–35.CrossRefPubMedPubMedCentral
Metadaten
Titel
Postmortem computed tomography and magnetic resonance imaging facilitates forensic autopsy in a fatal case of poisoning with formic acid, diphenhydramine, and ethanol
verfasst von
Florian Berger
Andrea E. Steuer
Katharina Rentsch
Dominic Gascho
Stamatios Stamou
Sarah Schärli
Michael J. Thali
Thomas Krämer
Patricia M. Flach
Publikationsdatum
18.07.2016
Verlag
Springer US
Erschienen in
Forensic Science, Medicine and Pathology / Ausgabe 3/2016
Print ISSN: 1547-769X
Elektronische ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-016-9797-6

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