Pulmonary Histopathology and Survival Period in Morphine-Involved Deaths

    Volume 41, Issue 3 (May 1996)

    ISSN: 0022-1198

    CODEN: JFSOAD

    Page Count: 5


    Madea, B
    Physicians, Institute of Forensic Medicine, University of Cologne, Koeln,

    Sticht, G
    chemist, Institute of Forensic Medicine, University of Cologne, Koeln,

    Grellner, W
    Physicians, Institute of Forensic Medicine, University of Cologne, Koeln,

    (Received 10 July 1995; accepted 18 October 1995)

    Abstract

    For an evaluation of the survival period in morphine-involved deaths, changes of pulmonary histopathology were investigated in a total of 90 morphine-associated fatalities. Although pulmonary histopathology proved to be heterogeneous, several distinctive histological patterns emerged. While the subgroup with short courses of intoxication (<1 h, n = 15) was mostly characterized by slight/moderate alveolar edema (12/15), severe hemorrhages (12/15) and marked acute emphysema (9/15), the phenomena of massive edema (8/15), missing/slight hemorrhages (8/15) and absent/slight emphysema (11/15) dominated in the group with intermediate survival times (1–24 h, n = 15). Intravascular leukocyte accumulations (shock equivalents) occurred in the first group only once, but in the group with the longer survival time in 10 of 15 cases. Delayed deaths (>24 h, n = 4) were mainly characterized by purulent bronchitis/pneumonia. Those fatalities (n = 56) that could not be classified by anamnestic data were assessed by histological criteria. In comparison with the evaluation of the survival period by toxicological analyses, concordance was found in 46 cases. Pulmonary histopathology is not a tool for an exact graduation of survival time, but the combination of several key parameters can provide criteria for a differentiation between short (<1 h) and longer courses of intoxication.


    Paper ID: JFS13930J

    DOI: 10.1520/JFS13930J

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    Author
    Title Pulmonary Histopathology and Survival Period in Morphine-Involved Deaths
    Symposium , 0000-00-00
    Committee E30