Forensic features of pharmacobezoars.

Area of Science:

• Forensic Pathology
• Toxicology
• Gastroenterology

Background:

• Pharmacobezoars are rare complications of medication use, involving the aggregation of pharmaceutical materials.
• Understanding their formation and impact is crucial for forensic and clinical contexts.

Observation:

• Case 1: A gelatinous pharmacobezoar cast the bronchial tree in a fatal overdose.
• Case 2: Pharmacobezoars occluded the larynx and bronchus in a fatal mixed drug toxicity case.
• Case 3: A large esophageal pharmacobezoar was found in a combined carbon monoxide and drug toxicity fatality.

Findings:

• Autopsy revealed pharmacobezoars as the cause of airway occlusion in two cases, complicating drug toxicity.
• In the third case, a pharmacobezoar contributed to death alongside carbon monoxide and drug toxicity.
• These pharmaceutical aggregations can cause death through mechanical obstruction or drug elution.

Implications:

• Highlights the potential for pharmaceutical materials to cause fatal airway obstruction.
• Emphasizes the importance of considering pharmacobezoars in post-mortem examinations of drug-related deaths.
• Suggests a need for awareness among healthcare providers regarding this rare but lethal complication.