Hepatic glycogen staining. Applications in injury survival time and child abuse

Hepatic glycogen stores have long been known to decrease with starvation, trauma, acute stress, and shock. In this study, hepatic tissue was examined in 122 decedents ranging in age from 1 to 88 years who died of a variety of causes. Hepatic tissue was stained for glycogen/carbohydrates using the Best's carmine and/or period acid-Schiff (PAS)-alcian blue methods in 121 cases. The liver samples were evaluated for amount of staining, staining around hepatic injuries (if present), and presence of histologic abnormalities. Prominence of staining was decreased with increasing survival times after injury (P=.0001) and increasing postmortem interval. Staining along the edges of hepatic injuries was decreased in antemortem injuries but not in postmortem-induced injuries (P<.0001). If used in conjunction with circumstantial and autopsy information, hepatic glycogen/carbohydrate staining using the Best's carmine and PAS-alcian blue methods could greatly aid in the determination of injury survival times and the vital nature of questionable injuries in child deaths and other cases.