Browsing by Subject "Forensic pathology"

Now showing 1 - 3 of 3
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    Death Resulting from Pneumocephalus Complicating Endoscopic Food Bolus Retrieval in a Patient with Eosinophilic Esophagitis
    (Sage, 2016-12) Fuhs, Amy K.; Prahlow, Joseph A.; IU School of Medicine
    Pneumocephalus is a rare complication of esophagogastroduodenoscopy (EGD), but existing literature does not discuss pneumocephalus surrounding endoscopic food bolus retrieval. We present a death involving pneumocephalus complicating endoscopic food removal from the esophagus. A 40-year-old man presented with dysphagia and suprasternal discomfort 12 hours following chicken ingestion. On flexible endoscopy, chicken was visualized in the distal esophagus. After successful retrieval, a mucosal laceration was noted where the chicken had been lodged. He was unarousable following the procedure and was emergently transported to a hospital, where computed tomography scanning showed pneumocephalus. He was later declared brain dead. The case was referred for medicolegal autopsy. The brain was examined first, revealing rare air bubbles within meningeal vessels and numerous, diffuse petechiae-like hemorrhages within the brain parenchyma. The esophageal mucosa had focal discoloration and a partial thickness laceration; microscopic examination revealed eosinophilic esophagitis. Eosinophilic esophagitis is a known risk factor for food bolus impaction and should be suspected in such patients. Pneumocephalus is a rare possible complication of EGD for food bolus retrieval. In patients unresponsive after endoscopy, radiographic detection of potential pneumocephalus should be encouraged to enable timely therapy and improved outcomes, or to supplement autopsy in the event of patient death. Forensic pathologists should understand that pneumocephalus is a potential mechanism of injury/death in patients experiencing esophageal trauma, including injury incurred during EGD.
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    Potential Dextromethorphan-Induced Serotonin Syndrome Leading to Homicide and Suicide
    (Sage, 2024-01-30) Pavelka, Matthew M.; Kohr, Roland; Medicine, School of Medicine
    Limited case reports have been published regarding serotonin syndrome due to the combined effects of supratherapeutic levels of dextromethorphan and selective serotonin reuptake inhibitor. We report a case of an adolescent with postmortem findings suggestive of a diagnosis of serotonin syndrome-induced psychosis associated with a double homicide and suicide. Postmortem toxicology of the suicide victim was remarkable for elevated serotonergic metabolites of fluoxetine and dextromethorphan in a 14-year-old male.
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    Suicide by Bomb, with Decapitation
    (Sage, 2016-03) McLemore, Amanda M.; Prahlow, Samuel P.; Prahlow, Joseph A.; IU School of Medicine
    Suicide by explosion is rare outside of the context of terrorist activities. We present a case of a man with a history of explosives expertise who committed suicide by bomb/decapitation. The case serves to remind forensic pathologists of several important issues when presented with a case involving explosives, such as ensuring the safety of all those involved in the investigation and the importance of interagency cooperation. Potentially invaluable ancillary tests at autopsy include performing radiology, collecting trace evidence, retaining clothing, ensuring the positive identity of the decedent, and recognizing the importance of documenting injury types and patterns.