Rahman Nisreen Abdul, Das Siddhartha, Chaudhari Vinod Ashok, Nandagopal Suresh, Badhe Bhawana
Department of Forensic Medicine & Toxicology, JIPMER, Puducherry, India.
Toxicology division, Forensic Sciences Department, Chennai, India.
Egypt J Forensic Sci. 2017;7(1):8. doi: 10.1186/s41935-017-0002-1. Epub 2017 Jul 18.
Self-poisoning usually occurs by the ingestion of a single lethal compound and majority of the poisoning cases in our country are due to the pesticides. Suicide by ingestion of more than one poisonous substance is rare except alcohol and multiple drugs. To the best of our knowledge, suicidal ingestion of a mixture of rodenticide and battery acid has not been reported before in medical literature.
Here we are discussing a case of simultaneous ingestion of two poisonous substances, i.e., aluminium phosphide and battery acid. In general, an acid is mainly locally acting while metal phosphide is a systemic poison. Features suggestive of both these poisonous substances were noticed on clinical, autopsy and histopathological examination and supported by a positive chemical analysis report of viscera. Moreover, we analysed the possible reactions which may occur between these two compounds and their by-products outside and inside our body.
In cases where, combination of poisons is suspected a proper history, meticulous autopsy and ancillary investigation including histopathogy and analytical toxicology are required to conclude the cause of death and mechanism of poisoning.
自我中毒通常是由于摄入单一致命化合物引起的,我国大多数中毒病例是由农药导致的。除酒精和多种药物外,摄入不止一种有毒物质导致自杀的情况很少见。据我们所知,医学文献中此前尚未报道过同时摄入灭鼠剂和电瓶酸的自杀案例。
在此,我们讨论一例同时摄入两种有毒物质(即磷化铝和电瓶酸)的病例。一般来说,酸主要起局部作用,而金属磷化物是一种全身性毒物。在临床、尸检和组织病理学检查中均发现了提示这两种有毒物质的特征,并且内脏的化学分析报告呈阳性也提供了支持。此外,我们分析了这两种化合物及其在体外和体内的副产物之间可能发生的反应。
在怀疑存在多种毒物混合的情况下,需要详细的病史、细致的尸检以及包括组织病理学和分析毒理学在内的辅助调查,以确定死亡原因和中毒机制。