An autopsy case of corrosive gastritis caused by calcium polysulfide colloid preparation

Mutouhapu (610 hap) was a calcium polysulfide colloid preparation, which was sold as a bath salt in Japan. Herein, we report on the autopsy of a suicide case as a result of taking 610 hap orally and present histopathological findings with a focus on corrosive changes observed in upper gastrointestinal tract. The subject was a 60-year-old man who was discovered dead 200-300 m from his home. The site smelled of sulfur. Sixty parts per million hydrogen sulfide was detected in the oral cavity of the deceased. He had schizophrenia since junior high school. At autopsy, the oral and nasal cavities had a rotten-egg smell. Adipose tissues had green coloring. There was thickening and sclerosis of the gastric wall, and a green to pale yellow pseudomembrane-like substance was observed adhering to the gastric mucosa. Gastric content was 400 ml of green to pale yellow sludge. The distal portion of the stomach was highly contracted. Qualitative analysis for hydrogen sulfide was positive. Histological changes in the digestive tract were particularly notable in the stomach. Degeneration and necrosis of the mucosa and submucosa, degeneration of the submucosal fat, and dissection-like changes in the blood vessels of the submucosa were discovered. Basophilic lime granules were found on the mucosal surface. There were hypercontracture changes in the proper muscle layer of the pyloric region. The cause of death was hydrogen sulfide poisoning with associated corrosive gastritis.