Ohkubo Eriko, Kondo Takeshi, Nagasaki Yasushi
Medical Examiner's Office of Hyogo Prefecture, 2-1-31 Arata-cho, Hyogo-ku, Kobe, Hyogo 652-0032, Japan.
Department of Diagnostic Pathology, Takasago Municipal Hospital, 33-1 Araicho-kamimachi, Takasago, Hyogo 676-8585, Japan.
J Toxicol Pathol. 2020 Oct;33(4):287-290. doi: 10.1293/tox.2020-0036. Epub 2020 Jul 9.
Mutouhapu (610 hap) was a calcium polysulfide colloid preparation, which was sold as a bath salt in Japan. Herein, we report on the autopsy of a suicide case as a result of taking 610 hap orally and present histopathological findings with a focus on corrosive changes observed in upper gastrointestinal tract. The subject was a 60-year-old man who was discovered dead 200-300 m from his home. The site smelled of sulfur. Sixty parts per million hydrogen sulfide was detected in the oral cavity of the deceased. He had schizophrenia since junior high school. At autopsy, the oral and nasal cavities had a rotten-egg smell. Adipose tissues had green coloring. There was thickening and sclerosis of the gastric wall, and a green to pale yellow pseudomembrane-like substance was observed adhering to the gastric mucosa. Gastric content was 400 ml of green to pale yellow sludge. The distal portion of the stomach was highly contracted. Qualitative analysis for hydrogen sulfide was positive. Histological changes in the digestive tract were particularly notable in the stomach. Degeneration and necrosis of the mucosa and submucosa, degeneration of the submucosal fat, and dissection-like changes in the blood vessels of the submucosa were discovered. Basophilic lime granules were found on the mucosal surface. There were hypercontracture changes in the proper muscle layer of the pyloric region. The cause of death was hydrogen sulfide poisoning with associated corrosive gastritis.
Mutouhapu（610 hap）是一种多硫化钙胶体制剂，在日本作为浴盐出售。在此，我们报告一例口服610 hap导致自杀的尸检情况，并重点呈现上消化道观察到的腐蚀性变化的组织病理学结果。死者为一名60岁男性，在离家200 - 300米处被发现死亡。现场有硫磺气味。在死者口腔中检测到百万分之六十的硫化氢。他从初中起就患有精神分裂症。尸检时，口腔和鼻腔有臭鸡蛋气味。脂肪组织呈绿色。胃壁增厚、硬化，胃黏膜可见绿色至淡黄色伪膜样物质附着。胃内容物为400毫升绿色至淡黄色的淤渣。胃远端高度收缩。硫化氢定性分析呈阳性。消化道的组织学变化在胃中尤为显著。发现黏膜和黏膜下层变性、坏死，黏膜下脂肪变性，黏膜下血管呈剥离样改变。黏膜表面发现嗜碱性石灰颗粒。幽门区固有肌层有过度收缩变化。死因是硫化氢中毒伴腐蚀性胃炎。
