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腹部皮下脂肪中磷化铝的偶然发现——中毒病例化学分析结果的罕见报告

Incidental detection of aluminum phosphide in abdominal subcutaneous fat- a rare reporting of chemical analysis findings in poisoning cases.

作者信息

Datta Arijit, Goswami Dhara, Shukla Srushti, Galoria Darshan, Rana Pradip, Pan Arpan Kumar

机构信息

Department of Forensic Medicine, Pramukhswami Medical College & Sri Krishna Hospital, Bhaikaka University, Karamsad, Anand, 388325, Gujarat, India.

Department of Forensic Medicine, Gujarat Adani Institute of Health & Medical Sciences, Kaccha University, Bhuj, Gujarat, India.

出版信息

Forensic Sci Med Pathol. 2024 Oct 10. doi: 10.1007/s12024-024-00899-0.

Abstract

Aluminum phosphide (AlP) poses a significant health challenge in developing countries, primarily because of its accessibility to the unregulated market and the absence of specific antidotes. Although chemical analysis of routine viscera can provide valuable information regarding the type of poison present in the body during poisoning incidents, numerous factors can alter the test results of chemical analysis, such as decomposition changes, postmortem redistribution, and the chemical nature of drugs. Analytical methods are frequently impeded by the interference caused by coextracted putrefactive compounds, which can mask or alter the detection of drugs. This series of three cases is particularly noteworthy because it involves the postmortem detection of AlP in the abdominal subcutaneous fat of the deceased, a previously unreported occurrence. In the first case, the body showed findings of late postmortem changes, with stomach mucosa being congested and hemorrhagic, along with routine viscera, and abdominal subcutaneous fat was sent for toxicological analysis. To confirm these findings, in two further cases of suspected AlP poisoning, subcutaneous fat was sent along with routine viscera. Stomach mucosa in the other two cases showed findings similar to those in the first. In the third case, black paste-like material was noted as stomach content. All the cases revealed the presence of AlP in routine viscera samples and abdominal subcutaneous fat on gas chromatography-mass spectrometry (GC‒MS) analysis. Therefore, abdominal fat can serve as a suitable sample for toxicological analysis to identify the presence of AlP, even in cases with advanced putrefactive changes.

摘要

磷化铝(AlP)在发展中国家构成了重大的健康挑战,主要是因为它在不受监管的市场上容易获取且缺乏特效解毒剂。尽管对常规内脏进行化学分析可以为中毒事件期间体内存在的毒物类型提供有价值的信息,但许多因素会改变化学分析的测试结果,如分解变化、死后再分布以及药物的化学性质。分析方法常常受到共提取的腐败化合物干扰的阻碍,这些化合物可能掩盖或改变药物的检测结果。这一系列三起案例特别值得注意,因为它涉及在死者腹部皮下脂肪中进行死后磷化铝检测,这是此前未报告过的情况。在第一起案例中,尸体呈现出死后晚期变化的迹象,胃黏膜充血、出血,常规内脏也有类似情况,腹部皮下脂肪被送去进行毒理学分析。为了证实这些发现,在另外两起疑似磷化铝中毒案例中,皮下脂肪与常规内脏一起被送去检测。另外两起案例中的胃黏膜表现与第一起相似。在第三起案例中,胃内容物被发现是黑色糊状物质。所有案例在气相色谱 - 质谱联用(GC - MS)分析中均显示常规内脏样本和腹部皮下脂肪中存在磷化铝。因此,即使在有晚期腐败变化的案例中,腹部脂肪也可作为毒理学分析的合适样本以确定磷化铝的存在。

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