title: Macroscopic and histopathological aspects of chemical damage to human tissues depending on the survival time.
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.
authors.affiliation: 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. albertoamadasi@libero.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Amadasi
authors.affiliation: 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.
authors.forename: Guendalina
authors.initials: G
authors.lastname: Gentile
authors.affiliation: 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.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rancati
authors.affiliation: 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.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Zoja
mesh_terms: D000059:Accidents; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002057:Burns, Chemical / Q000473:pathology*; D002424:Caustics / Q000506:poisoning*; D005260:Female; D049429:Forensic Pathology; D041981:Gastrointestinal Tract / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D012189:Retrospective Studies; D013405:Suicide; D013997:Time Factors; D055815:Young Adult
chemical_list: D002424:Caustics
keywords: Accident; Cause of death; Chemical substances; Forensic pathology; Histopathological features; Suicide; Survival time