Thorne L B, Collins K A
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston 29425, USA.
J Forensic Sci. 1998 Sep;43(5):1074-6.
Foreign-body embolization is not an uncommon occurrence. However, to our knowledge, there are only ten reported cases of needle embolization associated with intravenous drug use. We report the sudden death of a 49-year-old white male with a known history of crack cocaine abuse. At autopsy, suspicious needle marks were noted on the right lower extremity. The lungs were of increased weight at 1000 and 1090 g and appeared edematous. The heart weighed 520 g and had a normal red-brown myocardium. Upon sectioning, a broken hypodermic needle of very small caliber was identified in the right ventricular myocardium protruding into the right ventricular chamber. This needle apparently traveled from the injection site to the right ventricle. The right ventricle was dilated and hypertrophied, and microscopic examination showed hyperemic myocardium surrounding the needle. Sections of lung showed numerous foreign-body type giant cells containing polarizable foreign material consistent with intravenous drug use. Toxicological analysis revealed the presence of ethanol (36 mg/dL), cocaine (0.098 mg/L), benzoylecgonine (2.16 mg/L), and morphine (0.841 mg/L). Urine and blood were positive for the presence of 6-monoacetylmorphine. Based on the toxicological analysis, the cause of death was determined to be cocaine and heroin toxicity, and the manner accidental. The needle embolus was considered an incidental finding.
异物栓塞并非罕见情况。然而，据我们所知，仅有10例与静脉吸毒相关的针头栓塞报告病例。我们报告了一名有快克可卡因滥用史的49岁白人男性突然死亡的病例。尸检时，在右下肢发现可疑的针痕。双肺重量增加，分别为1000克和1090克，外观呈水肿状。心脏重520克，心肌呈正常的红棕色。切片检查时，在右心室心肌中发现一根口径非常小的折断皮下注射针头，针头突入右心室腔。这根针头显然是从注射部位进入右心室的。右心室扩张且肥厚，显微镜检查显示针头周围心肌充血。肺组织切片显示有许多异物型巨细胞，含有与静脉吸毒相符的可极化异物。毒理学分析显示存在乙醇（36毫克/分升）、可卡因（0.098毫克/升）、苯甲酰爱康宁（2.16毫克/升）和吗啡（0.841毫克/升）。尿液和血液中6-单乙酰吗啡检测呈阳性。根据毒理学分析，确定死亡原因是可卡因和海洛因中毒，死亡方式为意外。针头栓子被认为是一个偶然发现。
