{"id":1419,"date":"2023-08-23T22:30:38","date_gmt":"2023-08-24T02:30:38","guid":{"rendered":"http:\/\/wordpress.forensicpath.us\/?p=1419"},"modified":"2023-11-24T21:36:47","modified_gmt":"2023-11-25T02:36:47","slug":"pathology-cases-asphyxia-due-to-feces-aspiration","status":"publish","type":"post","link":"https:\/\/wordpress.forensicpath.us\/index.php\/2023\/08\/23\/pathology-cases-asphyxia-due-to-feces-aspiration\/","title":{"rendered":"Pathology cases — Asphyxia due to feces aspiration"},"content":{"rendered":"

This is the case of a middle-aged male with severe psychiatric problems and a history of self harm who had threatened suicide while incarcerated.\u00a0 He was placed on suicide watch but was found dead.\u00a0 When EMTs arrived, they found the decedent with his hands covered with feces and suctioned feces from his airways during intubation.\u00a0 Resuscitative attempts were unsuccessful.\u00a0 At autopsy, no aggregates of fecal material were noted, but the lungs expressed copious foul smelling fluid.<\/p>\n

The histology was interesting.<\/p>\n

Here’s a low power whole slide panorama of a section of lung.\u00a0 \u00a0Notice that the alveoli look pretty good.\u00a0 What’s odd is the expansion of the lymphatics:<\/p>\n

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Here’s a low power shot of an area of lymphatic expansion:<\/figcaption><\/figure>\n

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Here are some close shots of gunk in the lymphatics.<\/p>\n

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Note the pigmented debris.\u00a0 Here are more closeup shots:<\/p>\n

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The pigmented debris are largely birefringent:<\/p>\n

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This is consistent with fecal material.<\/p>\n

I’m not sure how it got into the lymphatics while there really isn’t much in the bronchi, at least at this level.\u00a0 I can’t help but wonder if there wasn’t a break in the mucosa higher up in the bronchial tree that allowed the liquid feces into the lymphatics.\u00a0 \u00a0I’m not sure how long the decedent survived after his effort, but it wasn’t more than an hour.\u00a0 He was subject to resuscitative efforts for another hour or so.\u00a0 Nonethless, I haven’t seen this kind of thing in the lymphatics in a long time.<\/p>\n

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 <\/p>\n","protected":false},"excerpt":{"rendered":"

This is the case of a middle-aged male with severe psychiatric problems and a history of self harm who had…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[99,109,60,1],"tags":[59,56,65,25,26],"class_list":["post-1419","post","type-post","status-publish","format-standard","hentry","category-forensic-pathology","category-pathology-cases","category-photomicrographs","category-uncategorized","tag-autopsy","tag-histology","tag-lung","tag-microscopy","tag-photomicrography"],"_links":{"self":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1419","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/comments?post=1419"}],"version-history":[{"count":1,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1419\/revisions"}],"predecessor-version":[{"id":1429,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/1419\/revisions\/1429"}],"wp:attachment":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/media?parent=1419"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/categories?post=1419"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/tags?post=1419"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}