Postmortem computed tomography and magnetic resonance imaging facilitates forensic autopsy in a fatal case of poisoning with formic acid, diphenhydramine, and ethanol

• Published in: Forensic science, medicine, and pathology Vol. 12; no. 3; pp. 304 - 311
• Main Authors: Berger, Florian, Steuer, Andrea E., Rentsch, Katharina, Gascho, Dominic, Stamou, Stamatios, Schärli, Sarah, Thali, Michael J., Krämer, Thomas, Flach, Patricia M.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.09.2016; Springer
• Subjects: Acetaldehyde; Adult; Alcohol; Alcohol, Denatured; Burns, Chemical - diagnostic imaging; Burns, Chemical - pathology; Case Report; Central Nervous System Depressants - poisoning; Criminology and Criminal Justice; CT imaging; Diphenhydramine; Diphenhydramine - poisoning; Ethanol - poisoning; Female; Forensic Medicine; Forensic Pathology; Formates - poisoning; Formic acid; Humans; Hypnotics and Sedatives - poisoning; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Multidetector Computed Tomography; Organic acids; Pathology; Poisoning; Suicide; Fatal combined intoxication; Ethanol; Formic acid; Diphenhydramine; Virtopsy; Postmortem computed tomography; Postmortem magnetic resonance tomography
• ISSN: 1547-769X; 1556-2891
• DOI: 10.1007/s12024-016-9797-6

A case of fatal poisoning by ingesting formic acid, diphenhydramine, and ethanol by a 25-year-old woman who committed suicide is presented. Prior to autopsy, postmortem computed tomography and postmortem magnetic resonance tomography were performed and revealed severe damage to the stomach, the left thoracic wall, and parts of the liver. Imaging detected acid-induced fluid–fluid level within the thoracic cavity (fat-equivalent fluid and necrotic pleural effusion). This case report illustrates that postmortem cross-sectional imaging may facilitate dissection of severely damaged or complex regions, and may provide additional information compared to autopsy and toxicological examinations alone.