Silica-containing products at autopsy: An uncommon incidental finding

Silica-containing products are widely encountered in consumer and pharmaceutical packaging as moisture-absorbing agents. Although generally considered non-toxic, accidental ingestion of silica desiccants has been documented in pediatric and elderly populations and may result in mechanical complications such as choking or gastrointestinal obstruction, particularly with cylindrical canister formulations. The authors present two rare forensic cases in which silica desiccant material was found within the gastrointestinal tract during postmortem examination. Case 1 involved a 39-year-old woman with a history of daily silicate ingestion based on alternative medicine beliefs, in whom sandy material was identified in the stomach; despite a complete autopsy, cardiovascular pathology consultation, and expanded toxicologic testing, no cause of death was identified, and the case was certified as undetermined. Case 2 involved a 63-year-old man found deceased in a cold environment, in whom both a desiccant packet within the esophagus and a desiccant canister within the stomach were incidentally retrieved; cause of death was certified as combined drug toxicity with environmental cold exposure as a contributing factor. In both cases the silica material was not considered a contributing factor to the death. At autopsy, it is critical to recognize silica-containing products when present, exclude mechanical airway compromise as a contributory mechanism, and avoid erroneous attribution of cause of death to silica toxicity, as current literature does not support a toxicologic effect of these compounds at typical ingestion doses.