Suicidal Ingestion of a Caustic Substance: A Case Report

In infants and children accidental ingestion of caustic substances can occur, in adults otherwise chemical exposure may be related to suicidal behaviors. Acid or alkali agents can cause chemical burns from mild to extensive injuries in digestive tract mucosa. Sometimes death due to an organ perforation occurs. The authors present a case of a 48-year-old man, found dead in his apartment, wearing only pants and socks. Near the body no objects or substances. A caustic substance was then found inside his car. Autopsy and chemical investigations were performed. The external examination of the body showed no traumatic injuries, except for some burn perioral lesions. At the autopsy, were found esophageal brownish mucosa, necrosis of the stomach, thrombosis of the gastric vessels and dark peritoneal fluid coating the bowels. Histological analyses of gastric mucosa showed cells with intensely eosinophilic cytoplasm and with condensation and fragmentation of nuclei and their progressive loss. Chemical investigations were made but did not provide useful information. Considering the circumstantial data and the autopsy findings, death was attributed to caustic ingestion. Severity of caustic exposure depends on the type of the substances but alkali may play a direct role in the lethal process by digestive burns, producing liquefaction necrosis.