TY - JOUR PY - 2011// TI - Multivisceral necrosis after sulphuric acid ingestion: A case report JO - Revue de médecine légale A1 - Bouabdellah, S. A1 - Hannache, K. A1 - Benmati, A. A1 - Bouhroum, A. A1 - Tidjani, B. A1 - Boudraa, Z. A1 - Benharkat, A. A1 - Bedar, L. A1 - Tebbi, Z. A1 - Roula, D. SP - 137 EP - 142 VL - 2 IS - 3 N2 - INTRODUCTION: Our observation gives a progress report on a particular aspect of multivisceral necrosis of discovery autopsic after a suicide by massive ingestion of concentrated sulfuric acid. Observation: Men 39 years old, hospitalised for epigastric pain, vomiting and haematemesis after having ingested voluntarily 750. cc of battery acid (32 %). The abdominal examination found an epigastric sensitivity and the pharyngeal examination objectived diffuse ulcerations of the oral cavity. The esogastroduodenal fibroscopy could not be made at our patient because the episodes of haematemesis became important. In day 5, after ingestion, he installs a multivisceral failure. Autopsic data: The external cadaveric examination was without characteristics. We found ulcerations of oral cavity and we have objectified a mesenteric necrosis and intraperitoneal hemorrhagic liquid. The normal aspect of the tongue contrasted with an oesophageal necrosis with perforation of the oesophagus and the stomach. Necrosis had also found also in the duodenal-pancreatic block, and the liver. The anatomo-pathological examination had objectified a coagulation necrosis of oesophageal, gastric and duodenal epithelium, with necrosis of hepatocyts.

DISCUSSION: In our case, only the anamnestic analysis of the characters from ingestion and the toxicological properties of the product were sufficient to predict gravity of the gesture and its serious consequences, because neither clinical and paraclinical examination could not determine the extent of the multivisceral necrosis process.

CONCLUSION: Rare aspect of multivisceral necrosis during a chemical peritonitis, particularly by the extent of the anatomical damage; but especially by the absence of parallelism between the severity of the injuries and the discretion of clinical symptoms. © 2011 Elsevier Masson SAS.

Language: fr

LA - fr SN - 1878-6529 UR - http://dx.doi.org/10.1016/j.medleg.2011.06.001 ID - ref1 ER -