Black and White in Toxicology, Virtual Autopsy Findings in Intentional Acid Ingestion

Analytical toxicology using postmortem viscera, blood, or urine samples is the established method for the detection of poison or intoxicating substances in cases of fatal poisoning. Medico-legal postmortem cases with undiagnosed/concurrent COVID-19 infection posed a challenge to the autopsy surgeons during the COVID-19 pandemic. However, during the initial pandemic, confusion was encountered related to the retrieval of samples for analysis from autopsy procedures. Until clear guidelines were issued, analytical laboratories were also reluctant to analyse the samples due to the spread of the virus. Hence, the authors intend to share the experience of solving an intentional acid ingestion during the initial pandemic, adhering to Minimal/Non-invasive methods. The feasibility of using advanced radiological techniques like PMCT was explored in determining the cause of death for legal purposes in these circumstantially confirmed poisoning cases due to corrosives.

The author here describes two different deaths due to corrosive ingestion, whose autopsy was conducted in the Department of Forensic Medicine and Toxicology, of a tertiary institute. The police investigation and circumstantial evidence revealed the corrosive ingestion. In both scenarios, the deceased expired due to gastric perforation and related complications. The same findings were observed in Post Mortem Computed Tomography (PMCT) and corroborated with the conventional autopsy findings.

These cases highlight the scientific use of the Virtual Autopsy using PMCT in concluding the cause of death for corrosive poisoning cases with clear-cut circumstantial evidence supplanting or at times substituting the explorative dissection and analytical techniques on a case-by-case basis.