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Pulmonary Histopathology and Survival Period in Morphine- Involved Deaths

NCJ Number
164336
Journal
Journal of Forensic Sciences Volume: 41 Issue: 3 Dated: (May 1996) Pages: 433-437
Author(s)
W Grellner; B Madea; G Sticht
Date Published
1996
Length
5 pages
Annotation
For an evaluation of the survival period in morphine- involved deaths, changes of pulmonary histopathology were investigated in 90 morphine-associated fatalities.
Abstract
Although pulmonary histopathology proved to be heterogeneous, several distinctive histological patterns emerged. Although the subgroup with short courses of intoxication (less than 1 hour, 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 hours, 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 death (greater than 24 hours, 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. Compared 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 (less than 1 hour) and longer courses of intoxication. 4 tables, 7 figures, and 22 references