Gastrointestinal hemorrhage in aluminum phosphide poisoning.

Poisoning, both accidental and intentional, is a significant contributor to the mortality and morbidity throughout the world. The commonest pesticide poisoning is organophosphates followed by phosphides. Ingestion of phosphides can induce severe gastrointestinal irritation leading to hemorrhage and ulcerations. Gastrointestinal hemorrhages and ulcerations beyond the duodenum have not been reported in the literature. Here, we report a case of severe hemorrhages and ulcerations in stomach, duodenum, jejunum, and ileum observed in a 45-year-old male who had consumed five tablets of Celphos(®) (each 3 g with 56% aluminum phosphide and 44% Ammonium carbonate) to commit suicide. He started vomiting after consumption, and the vomitus was blood-tinged. Once the treatment was instituted, he was stable for a day and thereafter his condition gradually deteriorated. He died on the 4th day of hospitalization, and autopsy revealed features of multiorgan failure and extensive gastrointestinal hemorrhages.

Sudden neuropathological deaths: An autopsy study.

BACKGROUND: Sudden or unexpected death can occur from unnatural causes, such as violence or poisoning, as well as from natural causes. Second to cardiac causes, neuropathology is one of the main causes of sudden natural death. In spite of the increasing incidence of neuropathological deaths, few studies have been conducted in Asia - hence the reason for the present study. METHODS: A 10-year (January 2003 to December 2012) retrospective study was conducted at the MS medico-legal institute in a metropolitan city of southern India. All the cases of sudden natural death, where the cause of death was opined to be due to a neuropathology after meticulous medico-legal autopsy and chemical analysis, were included. RESULTS AND CONCLUSIONS: A total of 7520 reported deaths were investigated. These included 291 sudden natural deaths, amongst which the death was attributed to neuropathology in 43 cases (14.7%). Of these 43 cases, 69.7% were male and 30.3% were female. The majority of cases (25.5%) were in those aged ≥60 years. Causes of neuropathology were due to subarachnoid haemorrhage in 48.8% of cases, stroke in 30.2%, meningitis in 14% and tumours in 7%. There was history of hypertension in 46.5% of cases, diabetes in 32.5% of cases and cardiac disease in 18.6% of cases.