Radiopaque stomach contents in postmortem CT in suicidal oral medication intoxication: Report of three cases
Received 12 February 2008; received in revised form 16 August 2009; accepted 29 October 2009.
Abstract
In clinical medicine, plane radiography is used for detecting the remains of medications in the stomach in oral medication intoxication cases. Since postmortem computed tomography (CT), performed prior to autopsy, is currently intensively entering the forensic routine, the technique was applied to three fatal cases of oral medication intoxication. Here we report CT and autopsy findings for these cases.
In all three cases, hyperdense areas within the stomach content were documented. The measurement of Hounsfield Units (HU) beyond 74HU showed mean values of 338, 88 and 98HU. Postmortem CT also showed brain edema and pulmonary aspiration in one case. At autopsy, tablet remains in the stomach were detected microscopically in all three cases. The ex vivo CT scans of the ingested medicaments showed similar HU values.
Despite the fact that further case studies are necessary beyond this one, and in spite of its limitations, postmortem CT was found to be a useful screening and documentation method for stomach contents in oral medication intoxication.
aInstitute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland
bInstitute for Evaluative Research in Medicine, University of Bern, Stauffacherstrasse 78, CH-3014 Bern, Switzerland
cInstitute for Diagnostic Radiology, University Hospital of Bern, Inselspital, CH-3010 Bern, Switzerland
Corresponding author. Address: Institute for Evaluative Research in Medicine, University of Bern, Stauffacherstrasse 78, CH-3014 Bern, Switzerland. Tel.: +41 31 631 59 40; fax: +41 31 631 59 31.
ABSTRACT