Pathology of volatile substance abuse: a case report and a literature review

The medicolegal importance of volatile substance abuse, as an example of toxicological deaths, is reviewed. A case of a 13-year-old boy who died after inhalation of volatile substances from a deodorant spray tin is presented. Another similar case has been summarized in the discussion. Different aspects of volatile substance abuse are considered with special emphasis on those facets which are relevant to forensic pathology practice. The most important pathological alterations associated with the acute and chronic abuse of volatile substances are discussed and some histological features of these conditions are illustrated with photographs. These include some microscopic changes of the central nervous system, respiratory system and the kidneys. The roles of the pathologist and the toxicologist in the investigations of the fatalities resulting from the volatile substance abuse are reviewed and practical points are explained. Lastly, some relevant legal points are discussed.