Citation

Mittal C, Gupta V, Meshram VP, Kanchan T, Setia P, Bharti JN, Sarangi S, Malik S. J. Forensic Sci. 2021; 66(5): 1992-1995.

Copyright

(Copyright © 2021, American Society for Testing and Materials, Publisher John Wiley and Sons)

DOI

10.1111/1556-4029.14738

PMID

33893644

Abstract

Corrosive digestive tract injuries are considered to be a source of morbidity and mortality worldwide. The cases of acid ingestion in Forensic Medicine practice are not infrequent. Corrosive ingestion usually presents with injuries over the face, oropharynx, esophagus, and gastrointestinal tract. We report a case of a 65-year-old woman who was brought to the emergency department with a history of ingestion of toilet cleaner at her home. Following this, she developed blackish-brown discoloration over the abdomen. The patient survived for less than one day. An autopsy confirmed the perforation of the stomach and small intestine. 500 ml of blackish fluid was present in the peritoneal cavity which resulted in corrosive peritonitis. The chemical examiner's report showed corrosive mixtures comprising sulfate, nitrate, and chloride ions in the peritoneal contents. This case report highlights atypical cutaneous presentation over the abdomen following corrosive acid ingestion, which has not been reported previously. The possible explanation for this cutaneous manifestation was corrosive effects of the underlying viscera due to its close proximation to the abdominal wall and presence of minimal intra-abdominal fat. A direct physical connection between perforation and cutaneous findings was not identified. The case emphasizes the need for a comprehensive approach in managing such cases, analyzing ingested material, and following standard autopsy protocols in case of death.

Language: en

Keywords

Humans; Aged; Female; suicide; India; autopsy; Abdomen; forensic pathology; peritonitis; Peritonitis; Caustics; perforation; Burns, Chemical; corrosive acid ingestion; Gastrointestinal Tract; Pigmentation Disorders