title: Radiopaque stomach contents in postmortem CT in suicidal oral medication intoxication: report of three cases.
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.
authors.affiliation: Institute of Forensic Medicine, University of Bern, Buehlstrasse 20, CH-3012 Bern, Switzerland. emin.aghayev@memcenter.unibe.ch <emin.aghayev@memcenter.unibe.ch>
authors.forename: Emin
authors.initials: E
authors.lastname: Aghayev
authors.forename: Christian
authors.initials: C
authors.lastname: Jackowski
authors.forename: Andreas
authors.initials: A
authors.lastname: Christe
authors.forename: Michael
authors.initials: M
authors.lastname: Thali
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000927:Anticonvulsants / Q000506:poisoning; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning / Q000652:urine; D014150:Antipsychotic Agents / Q000506:poisoning; D003987:Dibenzothiazepines / Q000506:poisoning; D049429:Forensic Pathology; D053593:Forensic Toxicology; D005766:Gastrointestinal Contents / Q000000981:diagnostic imaging*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000097:blood / Q000506:poisoning; D008297:Male; D008875:Middle Aged; D013405:Suicide; D013607:Tablets; D014057:Tomography, X-Ray Computed; D014299:Trimipramine / Q000506:poisoning / Q000652:urine; D014635:Valproic Acid / Q000506:poisoning
chemical_list: D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D006993:Hypnotics and Sedatives; D013607:Tablets; D014635:Valproic Acid; D014299:Trimipramine; C084602:clothiapine