Postmortem transport of gastric contents?

For the determination of the time since death, the distribution of the last meal in the stomach and small bowel may be of great importance. It may be even more difficult to estimate the time if there is a possibility that postmortem peristaltic emptying of the gastric content occurs, as has been claimed. Radiological control immediately after death by means of applying barium sulfate to the stomach, however, revealed no evidence of peristaltic emptying of the gastric content after death.     

DNA analysis of digested tomato seeds in stomach contents

Examination of stomach contents is one of the important steps in medical legal autopsy. Vegetative materials such as stems, roots, and seeds in stomach contents can be valuable evidence for providing investigative leads in death investigation. Currently, the identification of plant materials relies on microscopic and morphologic examination. We have found that many seeds are often protected from acid degradation during stomach digestion by their tough exterior seed coat. Tomato seeds were selected as a model system to assess DNA analysis and plant variety marker identification. The DNA-amplified fragment length polymorphism method was performed to determine if the DNA obtained from single seeds could be used for PCR analysis. From the amplified fragment length polymorphism results, some candidate markers for individualizing seeds from morphologically distinct tomatoes were identified. These data on DNA analysis of tomato seeds indicate amplified fragment length polymorphism is a viable procedure for the individualization of seeds from stomach contents in forensic investigations.     

A rare case of lethal methadone intoxication of a 3-week-old infant

The authors describe a rare case of lethal methadone intoxication of a 3-week-old infant. Born of a drug-addicted mother who was undergoing methadone substitution therapy, the newborn presented withdrawal symptoms and was immediately admitted to a paediatric ward where it was treated for 3 weeks, without administration of methadone. The infant died during bottle feeding within 24 h following discharge home.A post-mortem examination was performed as well as histopathological, toxicological and genetic tests were carried out in order to establish the cause and mode of death.The autopsy revealed obstruction of the lower air passages by stomach contents along with classical features of asphyxia. Toxicological tests revealed high concentrations of methadone and its metabolite in blood and urine as well as presence of methadone in stomach contents, and the DNA polymorphism analysis of the (sex-specific) amelogenin locus gave a negative result.On the basis of the results of the post-mortem examination, the laboratory tests and the police investigation, it was concluded that the drug was ingested with the bottle milk, and the possibility of administration of methadone at the hospital or its ingestion with the breast milk was precluded. Though both the cause and mode of death were established, the public prosecutor discontinued proceedings in the case due to inability to find the perpetrator.     

Scanning electron microscopy determination of string mozzarella cheese in gastric contents

As part of a suspected homicide investigation, a sampling of the gastric contents from the victim was forwarded to the U.S. Food and Drug Administration's Forensic Chemistry Center (FCC) for analysis of specific, selected components. The victim was known to have consumed string mozzarella cheese, as a snack, less than 24 h before his disappearance and the subsequent discovery of the body. The investigation sought to confirm or dismiss speculation the victim may have been fed a meal or eaten additional food prior to his death. Analysis of the stomach contents involved examination by stereoscopic light microscopy (SLM) and isolation, processing, and analysis of suspect materials by scanning electron microscopy (SEM). Several wax-like, off-white to cream-colored objects were noted by SLM examination and removed from the gastric contents. Through a series of fixation, sectioning, drying, and coating steps, these objects were prepared for analysis by SEM. Comparison of the suspect material with laboratory control string mozzarella cheese showed excellent correlation between the analyzed samples, confirming the suspect material from the stomach contents as string mozzarella cheese.     

溴敌隆及其代谢物-苄叉丙酮在犬体内的死后分布

目的研究溴敌隆及其代谢物-苄叉丙酮在中毒致死犬体内死后分布规律,为溴敌隆中毒检材的采取提供实验依据。方法分别经口给予犬2倍和4倍LD_(50)溴敌隆,待其死亡后迅速解剖取材,气相色谱-质谱联用法测定心血、外周血、尿、胆汁、心、肝、脾、肺、肾、脑、左下肢肌、膀胱、胃、胃内容、胰等脏器和体液中溴敌隆和代谢物-苄叉丙酮的含量。结果犬经2倍和4倍LD_(50)溴敌隆灌胃染毒后3d开始出现出血症状,(178.40±20.94)h后死亡。溴敌隆和代谢物-苄叉丙酮在各组织脏器及体液中的死后分布为:溴敌隆2LD_(50)组溴敌隆:胆汁尿、肝、心、肾心血、外周血、脾、肺等;苄叉丙酮:胆汁、尿、心血、外周血、肺、胃内容中含量高于其他脏器。溴敌隆4LD_(50)组溴敌隆:胆汁、尿肝、外周血心血、胃内容物等脏器。苄叉丙酮:胆汁、尿、肺浓度高于其他脏器。结论溴敌隆及其代谢物-苄叉丙酮在中毒致死犬体内死后分布不均匀,溴敌隆在胆汁、尿、肝脏、心血和外周血含量较高,代谢物-苄叉丙酮在胆汁、尿、肺较高。胆汁、尿、肝脏、心血、外周血可作为疑似溴敌隆中毒毒物分析的检材。     

Concentrations of toluene in the body killed by an injury to the head shortly after ingesting thinner

An autopsy was conducted on a male showing leather-like skin damage, revealing the cause of death to be an injury to the head. Thinner was found scattered around the scene of death, and stomach and intestine contents smelled strongly of solvent. Toxicological analysis was conducted to determine whether or not the solvent was of a lethal level. Using gas chromatography, peaks of toluene, xylene, and ethylbenzene were detected in the blood and gastric contents. No toluene was detected in the urine, and therefore it was concluded that the decedent died of a severe head injury shortly after solvent ingestion. In the literature, toluene concentrations in blood and lung samples were determined as both fatal and non-fatal but clear differences in the fatality of toluene in solid organ samples, namely, the brain, liver and kidneys were shown. The brain is especially useful in postmortem analysis. In this case, the concentration of toluene in the brain was 20.0 microl/g, which was considered as a non-lethal level.     

An unusual case of post-mortem redistribution of ethanol

We report an unusual case of post-mortem redistribution of ethanol in a woman diver who died by drowning in seawater. The ethanol concentrations were right heart blood 0.60 g/l, left heart blood 2.08 g/l, femoral venous blood 0.63 g/l, gastric contents 5.87 g/l, bile 0.83 g/l. The mechanisms of post-mortem redistribution of ethanol described in the literature, that is, early redistribution from the stomach or the lung parenchyma in the case of inhalation of gastric contents, are inadequate to account for the degree of variation observed between the measurements. We believe that this difference in concentration is explained by the presence of seawater in the pulmonary alveoli at the time of death.     

A fatal methamphetamine poisoning associated with hyperpyrexia

After self-administration of 0.05g of methamphetamine hydrochloride intravenously on three occasions at intervals of 3h, a 25-year-old female methamphetamine abuser ingested approximately 1.5 g of methamphetamine hydrochloride, and was found dead 3–4 h later. Complete rigor mortis was observed 1–2 h after death and the rectal temperature was 38.4°C 3–4 h after death.Distribution of methamphetamine and amphetamine in the body was analyzed by chemical ionization mass fragmentography. Amphetamine/methamphetamine concentrations (μ mol/100 g) were $\text{0.26}\text{28.8}$ in blood, $\text{0.64}\text{68.2}$ in brain, $\text{0.96}\text{117.1}$ in liver, $\text{0.53}\text{50.6}$ in kidney, and $\text{1.49}\text{1045}$ in stomach contents. Total amount of methamphetamine hydrochloride in stomach contents was 11.6mg.Amphetamine in tissues was a metabolite of methamphetamine, and amphetamine in stomach contents resulted from excretion into saliva and gastric mucous excretion. With rectal temperature at death estimated at more than 41°C, it would seem that hyperpyrexia played an important role in causing death from methamphetamine poisoning.     

Aspiration of gastric contents in hanging with typical position of the strangulation cord and free suspension]

Among 193 cases of hanging from the years 1978 to 1991 examined in the institute of Forensic Medicine of the Freie Universit?t Berlin 8 cases with an aspiration of stomach contents had been reported. Herefrom 3 cases were hanging in a "typical" position (suspension point at the back of the head, free suspension of the hanging body) and did not undergo resuscitation. By free suspension of the hanging body the observed massive aspiration of gastric contents only can be explained by an at least partly open connecting passage between the laryngeal entry and the entrance of the oesophagus. The post mortem flowing in of stomach contents as well as a post mortem gastro-oesophageal peristalsis seem not to be able for explicating the findings. Differences in important parameters (e.g. gastric contents, alcoholization) to the cases of hanging without aspiration were not found. Even by free suspension of the body, running noose and point of suspension in the back of the neck sometimes the connection between larynx and oesophagus may stay open, especially when by emesis a high pressure is produced by the stomach.     

The determination of toxic metals in simulated stomach contents by energy dispersive X-ray fluorescence analysis and a fatal case of mercury poisoning

Soup is used as a simulated stomach contents matrix to determine the lower level of detection for 16 metals. All of the metals can be detected at the levels which might be expected for acute fatal doses even if the stomach contents are considerably diluted. However where small doses are administered over a prolonged period this method may not be sufficiently sensitive. A case of fatal poisoning by the ingestion of mercuric chloride is described to illustrate the effectiveness of the method. In this case mercury was also detected and determined at highly significant levels in blood and liver by the same technique. This energy dispersive X-ray fluorescence (EDXRF) method is easy to use, rapid and non-destructive.     

Morphine Concentrations in Stomach Contents of Intravenous Opioid Overdose Deaths

Abstract:  Death caused by heroin overdose is almost always the result of intravenous injection of the drug in Australia. We briefly describe a case where a heroin overdose was initially thought to be the result of oral ingestion of the drug, primarily as a result of higher concentrations of morphine in stomach contents than in blood. During the subsequent criminal trial and investigation, however, the issue of the entero-hepatic circulation of morphine was raised as a possible reason for the presence of morphine in the stomach contents. In this study, we report on the distribution of opioids in blood, stomach contents, urine, liver, and bile in 29 deaths caused by intravenous heroin overdose. The mean total and free blood morphine concentrations were 0.60 and 0.32 mg/L , respectively, and the mean stomach contents total morphine concentration was 1.16 mg/kg. All cases had detectable morphine in the stomach contents, and 24 of 29 cases (83%) had higher concentrations of total morphine in stomach contents than in blood. The mean total morphine concentration in bile was c. 100 times that in blood, and the liver total morphine concentration averaged twice that of blood levels. We conclude that the entero-hepatic circulation of morphine and subsequent reflux of duodenal contents back into the stomach can result in the deposition of morphine in gastric contents. Consequently, the relative levels of opioids in blood and stomach contents cannot be used to determine the site of administration of the drug.     

A case of fatal intoxication with ammonium sulfate and a toxicological study using rabbits.

Agricultural fertilizers such as ammonium sulfate are widely used in house gardens as well as in agriculture, but few case reports or toxicological studies of ingested fertilizers have been reported. This paper investigates a fatal case of ammonium sulfate poisoning and demonstrates its clinical and biochemical findings in rabbits. An 85-year-old woman was found dead lying on the ground outside her house in the middle of March, but the autopsy could not determine the cause of her death. Examination at the police laboratory of the solution in the beer can found next to her showed that it was very likely ammonium sulfate. Our measurement showed a significant increase of ammonium and sulfate ions in serum and gastric contents. The cause of her death was determined as poisoning by ammonium sulfate. The total dose of 1500 mg/kg of ammonium sulfate was administered to three rabbits, all of which showed similar symptoms such as mydriasis, irregular respiratory rhythms, local and general convulsions, until they fell into respiratory failure with cardiac arrest. EEG showed slow, suppressive waves and high-amplitude slowing wave pattern, which is generally observed clinically in hyperammonemia in man and animal. There was a remarkable increase in the concentration of ammonium ion and inorganic sulfate ion in serum, and blood gas analysis showed severe metabolic acidosis. These results, mainly findings by EEG, have shown that a rapid increase in ammonium ions in blood can cause damaging the central nervous system without microscopic change. When the cause of death can not be determined, measurement of ammonium ion, inorganic ion and electrolytes in blood as well as in stomach contents at forensic autopsy is necessary.     

Enzyme assays for the identification of gastric fluid

Simple, reliable procedures for the assay of pepsin and rennin-like enzyme activities are described as a means of identifying gastric fluid-containing samples in forensic science laboratories. These samples are usually vomitus, or stomach contents originating from wounds that perforate the stomach. They may be encountered at scenes or on articles submitted for examination, in fresh form or as dried stains. The pepsin activity assay is based on proteolytic activity with bovine albumin as substrate and the rennin-like activity assay is based on the coagulation of milk protein.     

Fatal Datura poisoning: identification of atropine and scopolamine by high performance liquid chromatography/photodiode array/mass spectrometry

A forensic method comprising solid phase extraction and HPLC analysis was developed for the detection and confirmation of atropine and scopolamine, the main toxic alkaloids of Datura stramonium and Datura ferox. This method allowed the direct coupling of an electrospray (ZMD) mass selective detector to the HPLC system. Under these conditions, atropine and scopolamine were well separated from other components and detected on the PDA (LOD = 1 microg/ml) and ZMD (LOD(atropine) = 10 pg/ml; LOD(scopolamine) = 100 pg/ml) detectors. Four geographically isolated populations of each of D. stramonium and D. ferox were analysed for seed alkaloids and it was found that the two species were diagnostically different in their atropine-scopolamine ratios. The optimised HPLC method was used to analyse three viscera samples of an adult Caucasian male whose death was ascribed to a fatal heart attack. Atropine and scopolamine were detected in the stomach and its contents, which contained Datura seeds. The chemical profile of the seeds found in the stomach contents was similar to those from four geographically different D. ferox plants.     

Sudden Unexpected Death Due to Left Subclavian Artery‐esophageal Fistula Caused by Fish Bone

A 53‐year‐old woman was admitted to the hospital due to unexpected dizziness and died the following morning. To investigate the cause of death, a forensic autopsy along with histological examination was performed 3 days after her death. The major findings of the autopsy were that a fish bone had pierced the left subclavian artery after perforating the esophagus with 680 mL of blood in the stomach and bloody and tarry contents were present in the intestines, and the cause of death was confirmed to be subsequent hemorrhagic shock. Unfortunately, none of her family realized that she had eaten a fish 4 days before the tragedy until the fish bone was found. The present case is rare and instructive. The histopathological findings of left subclavian artery‐esophageal fistula induced by a fish bone can be used as a reference in forensic practice.     

Separation of stomach contents using the sieve-tower technique]

The authors present a method to separate and preserve stomach contents for forensic purpose. Analysis by "sieve tower" technique is simple and quickly done during autopsy. Solid phases of stomach content are arranged size up and can be stored for subsequent examinations. With the fluid phase drug analysis or microscopic analysis to confirm identy of the foodstuffs may be done. By adding alcohol (70%) enzymatic digestion and bacterial degradation of the stomach content are stopped.     

Wischnewsky's spots in an ectopic stomach

Wischnewsky's spots in the mucosa of the stomach have been a well-known sign of death due to hypothermia for many years. Furthermore it is reported that those spots can rarely be found in the esophagus as well. We now report on a case concerning a 93-year-old woman who presented an ectopic stomach with erosions of the mucosa in the intrathoracic part of the stomach that were assessed as Wischnewsky's spots. When she was found dead in her flat, she was completely undressed and showed an injury to the head. The autopsy findings are presented and discussed in view of a possible genesis and pathophysiology of Wischnewsky's spots.     

The appropriate use of subpopulation corrections for differences in endogamous communities

The bioluminescence response of two genetically modified (lux-marked) bacteria to potentially toxic compounds (PTCs) in stomach contents was monitored using an in vitro assay. Cells of Escherichia coli HB101 and Salmonella typhimurium both carrying the lux light producing gene on a plasmid (pUDC607) were added to stomach contents containing various concentrations of organic and inorganic compounds. There was some variability in the response of the two biosensors, but both were sensitive to the herbicides glyphosate, 2,4-dichlorophenoxyacetic acid (2,4-D), 2,4,5-trichlorophenoxyacetic acid (2,4,5-T); pentachlorophenol (PCP), and inorganic poisons arsenic and mercury at a concentration range likely to be found in stomach contents samples submitted for toxicological analysis. This study demonstrates that biosensor bioassays could be a useful preliminary screening tool in forensic toxicology and that such a toxicological screening should include more than one test organism to maximise the number of PTC's detected. The probability of false positive results from samples containing compounds that may interfere with the assay such as over-the-counter (OTC) drugs and caffeine in tea and coffee was also investigated. Of the substances tested only coffee has the potential to cause false positive results.     

Sudden infant death and liver phosphoenolpyruvate carboxykinase analysis

In an effort to substantiate the impaired gluconeogenesis-terminal hypoglycemia hypothesis of sudden infant death syndrome (SIDS), 52 infants ranging from 3 weeks to 7 months of age which had been brought to autopsy were studied. The stomach contents, vitreous humor glucose concentrations, hepatic glycogen content and hepatic phospho-enolpyruvate carboxykinase (PEPCK) activity were measured as part of the laboratory component of the postmortem investigation. The stomach contents, vitreous humor glucose concentrations and liver glycogen content were similar in SIDS/and non-SIDS victims. PEPCK activity was, however, significantly lower in SIDS (p < 0.001) victims and in SIDS with other findings (p < 0.01) victims when compared to non-SIDS victims. Despite the fact that SIDS victims had lower hepatic PEPCK activity and hence potentially lower gluconeogenic capacity, terminal hypoglycemia could not be demonstrated in this group as compared to the SIDS with other findings and the non-SIDS infants. The impaired gluconeogenesis-terminal hypoglycemia hypothesis thus could not be substantiated.     

Death caused by ingestion of endosulfan

This paper reports the autopsy and toxicological findings of a death caused by ingestion of endosulfan dispersed in a colorless liquid containing about 55% of xylene (w/v). For isolation of endosulfan, the biological material was homogenized and the drug was isolated by extraction with ether. Quantitative determinations were carried out by gas chromatography. The following concentrations of endosulfan were found: Blood 30 mg/L Gastric contents 0.5 g in the total 50 mL Liver 20 mg/kg Kidney 2.0 mg/kg Brain 0.3 mg/kg Xylene (solvent) was detected only in stomach contents (0.4 g in the total 50 mL).