Analysis on forensic pathology of water intoxication: A review

IF 1.3 4区医学 Q3 MEDICINE, LEGAL

Legal Medicine Pub Date : 2025-07-04 DOI:10.1016/j.legalmed.2025.102660

Treglia Michele , Volonnino Gianpietro , Huan Wan , Del Duca Fabio , Ping Yan , Maiese Aniello

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Abstract

Post-mortem diagnosis of water intoxication should be confirmed through analysis during an autopsy. Demonstrating typical tissue changes in accordance with the clinical history is useful for assessing the reliability of a hyperhydrated state. A review of current literature on autopsy cases involving excessive liquid intake was conducted, and a definition of pathological death due to water intoxication is proposed.

Analyzed cases revealed general cerebral and lung abnormalities along with significant right ventricular heart dilation. Histological findings included neuronal degeneration characterized by lax core chromatin, enlarged nerve cells, and perivascular spaces, often associated with neuronal necrosis. Cardiac findings included the absence of cardiomyocyte striations and vacuolation of cardiomyocytes.

Post-mortem blood examination (n = 5) showed a mean ± SD serum sodium concentration of 90.4 ± 12.8 mmol/L (Median = 85, IQR = 20.5; IQ1–3 = 81.5–102). Post-mortem blood sodium level appears to be a specific marker of recent excessive liquid intake. Post-mortem examination is necessary to evaluate the effects of electrolyte imbalance in cases of an anarcatic state.

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水中毒的法医病理学分析综述

水中毒的死后诊断应在尸检过程中通过分析加以确认。根据临床病史证明典型的组织变化对评估高水合状态的可靠性是有用的。回顾了目前有关过量液体摄入的尸检病例的文献，并提出了水中毒病理性死亡的定义。分析的病例显示一般的脑和肺异常，并伴有明显的右心室扩张。组织学表现包括以核心染色质松弛、神经细胞增大和血管周围间隙为特征的神经元变性，常伴有神经元坏死。心脏检查结果包括心肌细胞条纹消失和心肌细胞空泡化。死后血液检查（n = 5）显示血清钠浓度平均值±SD为90.4±12.8 mmol/L(中位数= 85,IQR = 20.5；iq1-3 = 81.5-102)。死后血钠水平似乎是近期液体摄入过量的一个特殊标志。死后检查是必要的，以评估在无政府状态的情况下电解质失衡的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Legal Medicine Nursing-Issues, Ethics and Legal Aspects

CiteScore

2.80

自引率

6.70%

发文量

119

审稿时长

7.9 weeks

期刊介绍： Legal Medicine provides an international forum for the publication of original articles, reviews and correspondence on subjects that cover practical and theoretical areas of interest relating to the wide range of legal medicine. Subjects covered include forensic pathology, toxicology, odontology, anthropology, criminalistics, immunochemistry, hemogenetics and forensic aspects of biological science with emphasis on DNA analysis and molecular biology. Submissions dealing with medicolegal problems such as malpractice, insurance, child abuse or ethics in medical practice are also acceptable.