Sudden death due to forced ingestion of vinegar

Vinegar is a clear colorless liquid that commercially consists of 5% acetic acid. It has numerous benefits in everyday use, including culinary, medical, and cleaning. The ingestion of concentrated acetic acid is strongly discouraged and may have detrimental consequences, such as acute pancreatitis, disseminated intravascular coagulopathy, gastric and hepatic complications, upper airway obstruction, or death. We report the first case in the literature of a 5-year-old boy who experienced a sudden death due to ingestion of distilled white vinegar. The manner was homicide. There was evidence of nonfatal blunt force impacts of the head, trunk, and extremities. A pungent aromatic odor of the viscera, gastric/small bowel contents, and cranial cavity was noted at autopsy. A dusky gray discoloration of the gastric mucosa, small bowel, and pancreas was observed. Forensic pathologists should consider ingestion of vinegar when confronted with a compelling history as well as an aromatic odor suggesting vinegar and dusky gray discoloration of the gastric mucosa and small bowel. While vinegar is a common household item and has several advantages, it may prove fatal if ingested in large quantities.