Department of Forensic Medicine, University Hospital-Charles Nicolle, 1 rue de Germont, 76031 Rouen Cedex, France.
Forensic Sci Int. 2012 Sep 10;221(1-3):e17-20. doi: 10.1016/j.forsciint.2012.04.006. Epub 2012 May 3.
Intentional absorption of sodium azide is exceptional but remains extremely life-threatening because death rapidly occurs when significant doses are absorbed, either due to the direct effect of sodium azide or an indirect effect due to nitric oxide, cyanide ions or hydrazoic acid production from sodium azide.
The body of a laboratory assistant, was discovered by his colleagues in the laboratory, seated on a chair located near a digital computer displaying information about sodium azide. Moreover, a half empty 99% sodium azide flask was found near the corpse. The laboratory staff confirmed that the young man was still alive 5h prior to discovery.
Postmortem examination did not show any cutaneous signs of injury due to a defensive struggle. Bilateral ungual cyanosis was observed as well as a major cerebral edema and visceral congestion on autopsy. The elevated sodium azide concentration found in the gastric sample and the amount of gastric content allowed to conclude that sodium azide intake was more than 6g which was above the lethal dose, i.e. approximately 1g. Surprisingly, no sodium azide was found either in blood and serum, or in hepatic and renal tissue samplings. However, major concentrations were observed in the gastric contents, bile and urinary samples, as well as in cardiac and cerebral tissues samples. No other toxic element was found. Therefore, the post-mortem findings, the autopsy and the analytical results suggested that the laboratory assistant died after an intentional sodium azide ingestion.
Sodium azide poisoning by ingestion has to date remained extremely rare and our case highlights the extreme lability of sodium azide as it was absent in the blood, in spite of significant concentrations in stomach content and some tissues. Therefore, the necessity of multiple tissues samples during autopsy should be underlined.
故意摄入叠氮化钠的情况非常罕见，但仍然极其危及生命，因为当摄入大量剂量时，无论是由于叠氮化钠的直接作用还是由于一氧化氮、氰化物离子或叠氮酸的产生而产生的间接作用，都会迅速导致死亡。
一名实验室助理的尸体被同事在实验室中发现，他坐在一把椅子上，椅子位于一台显示有关叠氮化钠信息的数字计算机附近。此外，在尸体附近发现了一个半满的 99%叠氮化钠瓶。实验室工作人员确认这名年轻人在发现前 5 小时还活着。
尸检未显示出由于防御性挣扎而导致的任何皮肤损伤迹象。双侧指甲发绀以及大脑水肿和内脏淤血。胃样本中发现的叠氮化钠浓度升高和胃内容物的量允许得出结论，即摄入的叠氮化钠超过 6g，超过致死剂量，即约 1g。令人惊讶的是，无论是在血液和血清中，还是在肝和肾组织样本中，都没有发现叠氮化钠。然而，在胃内容物、胆汁和尿液样本中以及心脏和脑组织样本中观察到了主要浓度。未发现其他有毒元素。因此，尸检结果、尸检和分析结果表明，实验室助理是在故意摄入叠氮化钠后死亡的。
迄今为止，摄入叠氮化钠中毒仍然极为罕见，我们的病例突出了叠氮化钠的极端不稳定性，因为尽管胃内容物和一些组织中存在显著浓度，但在血液中却不存在。因此，应该强调在尸检时进行多个组织样本的必要性。
