Postmortem Computed Tomography Findings Associated with Sudden Death in Alcoholics

Area of Science:

• Forensic pathology
• Radiology
• Toxicology

Background:

• Sudden natural deaths in alcoholics often show only fatty liver at autopsy.
• Postmortem CT (PMCT) characteristics of sudden alcoholic deaths are not well-documented.

Purpose of the Study:

• To investigate and report PMCT radiographic measurements in sudden alcoholic deaths.
• To compare these measurements with other causes of death (ischemic heart disease, starvation).

Main Methods:

• Radiographic measurements of PMCT in alcoholic (ALC) cases were analyzed.
• ALC cases were compared to ischemic heart disease (IHD) and starvation (SV) cases.
• Autopsy findings (heart blood volume, lung edema, fatty liver) were correlated with PMCT data.

Main Results:

• Alcoholic deaths showed significantly lower cardio-thoracic ratio, inferior vena cava area, and lung radiodensity compared to IHD.
• Liver radiodensity was significantly lower in alcoholic deaths, correlating with fatty liver extent.
• Alcoholic deaths often presented with low BMI (<18.0) and detectable blood acetone (87.5%).

Conclusions:

• Lower liver radiodensity and lack of pulmonary edema/vascular congestion on PMCT suggest severe fatty liver disease and metabolic disturbances in sudden alcoholic deaths.
• PMCT findings, combined with other analyses, can help distinguish sudden alcoholic deaths from other causes.