아크릴 접착체(디클로로메탄)을 이용한 사망: 증례 보고
Death Due to Acrylic Adhesive (Dichloromethane): A Case Report
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Deaths due to dichloromethane (DCM) poisoning are mainly caused due to accidents at industrial sites, and suicidal cases are known to be rare. Herein, we report a case of a 56-year-old man who worked as a technician and died after consuming DCM for suicidal motive. According to the investigations, he had left a recorded message on his phone for his wife, which suggested he committed suicide. At the scene, opened DCM and whiskey bottles were found; approximately 120 mL of the DCM was still in the bottle. No specific injuries were externally observed during the autopsy. Microscopic examination showed denudation of epithelium in the esophageal and gastric mucosa, and no inflammatory reaction proceeded. The denudation was accompanied by pulmonary edema, acute tubular necrosis in the kidneys, and microvesicular steatosis in the liver. The DCM was detected in blood, gastric contents, and nasal cavity fluid. The concentration of alcohol in the blood was found to be 0.487%. It was presumed that he died of acute DCM poisoning while drunk. In cases of suspicious acute and chronic DCM poisoning deaths, investigations of carboxyhemoglobin and the clinical chemistry of blood or body fluids are warranted to determine the cause and mechanism of death.
Abstract
Deaths due to dichloromethane (DCM) poisoning are mainly caused due to accidents at industrial sites, and suicidal cases are known to be rare. Herein, we report a case of a 56-year-old man who worked as a technician and died after consuming DCM for suicidal motive. According to the investigations, he had left a recorded message on his phone for his wife, which suggested he committed suicide. At the scene, opened DCM and whiskey bottles were found; approximately 120 mL of the DCM was still in the bottle. No specific injuries were externally observed during the autopsy. Microscopic examination showed denudation of epithelium in the esophageal and gastric mucosa, and no inflammatory reaction proceeded. The denudation was accompanied by pulmonary edema, acute tubular necrosis in the kidneys, and microvesicular steatosis in the liver. The DCM was detected in blood, gastric contents, and nasal cavity fluid. The concentration of alcohol in the blood was found to be 0.487%. It was presumed that he died of acute DCM poisoning while drunk. In cases of suspicious acute and chronic DCM poisoning deaths, investigations of carboxyhemoglobin and the clinical chemistry of blood or body fluids are warranted to determine the cause and mechanism of death.
참고문헌 (12)
- Korea Industrial Health Association, "The basis of TLV for the working environment, methylene chloride (dichloromethane)", Korea Ind Health, 123, pp.38~41 (1998)
- Jeong KC, "Industrial poisoning manual", pp.604~607 (1995), Shin Kwang Publisher
- Lee JJ, "A case of persistent axial ataxia precipitated by dichloromethane intoxication", Inje Med J, 38, pp.91~97 (2017)
- Yoo JH, "A case of dichloromethane intoxication following ingestion", J Korean Soc Emerg Med, 10, pp.128~132 (1999)
- Raphael M, "Acute methylene chloride intoxication : a case report on domestic poisoning", Eur J Emerg Med, 9, pp.57~59 (2002)
- Kim DH, "Effects of dichloromethane inhalation on the rat estrus sycle", Inje Med J, 19, pp.689~695 (1998)
- 하봉구, "주성분이 염화메틸렌(Methylene Chloride)인 재생 세척제를 취급하는 근로자에서 발생한 독성간염 1예", Annals of Occupational and Environmental Medicine, 16(2), pp.210~219 (2004), 대한직업환경의학회
- Manno M, "Double fatal inhalation of dichloromethane", Hum Exp Toxicol, 11, pp.540~545 (1992)
- Goulle JP, "Fatal case of dichloromethane poisoning", J Anal Toxicol, 23, pp.380~383 (1999)
- Takeshita H, "Postmortem absorption of dichloromethane : a case study and animal experiments", Int J Legal Med, 114, pp.96~100 (2000)
- "Prevention of health damage caused by methylene chloride, 2012-Occupational health-347" (2014)[URL]
- Chang YL, "Diverse manifestations of oral methylene chloride poisoning : report of 6 cases", J Toxicol Clin Toxicol, 37, pp.497~504 (1999)