Volume 46, Issue 5 (September 2001)

    Glycine Toxicity and Unexpected Intra-Operative Death

    (Received 31 May 2000; accepted 6 October 2000)

    CODEN: JFSOAD

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    Abstract

    A rare complication of the use of glycine irrigation fluid during prostatic surgery in a 69-year-old man is described. Following cystolithopexy and transurethral resection of the prostate for benign prostatomegaly, abdominal distension developed with increasing ventilatory pressures. Despite retroperitoneal fluid evacuation at subsequent urgent laparotomy, cardiac arrest occurred that was not amenable to resuscitation. At autopsy a traumatic defect in the posterior bladder wall filled with calculus debris was confirmed that did not communicate with the peritoneal cavity. Hyponatremia with markedly elevated levels of blood, urine, and body fluid glycine were demonstrated. Death was, therefore, attributed to glycine toxicity following tracking of glycine through a surgical defect in the posterior bladder wall. Careful dissection of surgical sites is required in such cases to demonstrate any additional trauma that may be associated with the fatal episode. Analysis of body fluids for glycine and electrolytes is also necessary to assist in the determination of possible mechanisms of death.


    Author Information:

    Gilbert, JD
    Forensic Science Centre, Adelaide,

    Byard, RW
    Forensic Science Centre, Adelaide,

    Harrison, R
    Women's and Children's Hospital, Adelaide,

    Wells, R
    Prince of Wales Hospital, Sydney,


    Stock #: JFS15130J

    ISSN: 0022-1198

    DOI: 10.1520/JFS15130J

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    Author
    Title Glycine Toxicity and Unexpected Intra-Operative Death
    Symposium , 0000-00-00
    Committee E30