Aspiration and Inhalation

  • Reinhard B. Dettmeyer


The aspiration and inhalation of materials and gases can sometimes cause characteristic and sometimes nonspecific histopathological findings. Water aspiration is relatively common, leading to histopathological findings in lung tissue (emphysema aquosum; hemorrhagic emphysema). Blood aspiration also occurs following medical interventions. The aspiration of fine soot dust or undigested food can sometimes only be detected histologically. Acute aspiration or inhalation can only be differentiated from chronic tissue damage due to aspiration or inhalation further in the past using histopathology techniques: the detection of pulmonary intra-alveolar siderophages or the demonstration of inflammatory fibrosis with foreign-body-type giant cells. This can be important in the detection of aspiration pneumonia, for instance. On the other hand, the importance of amniotic fluid aspiration of varying degrees of severity should be considered with caution in terms of cause of death. Cases of aspiration of, e.g., barium sulfate are rare. If there is a possibility that textile fiber inhalation has occurred, e.g., in the case of suffocation with a soft cover, the microscopic examination of bronchial lavage fluid is recommended. Histopathological findings following gas inhalation, which can cause severe inflammation in lung tissue and occasionally liver damage, tend to be nonspecific. Allergen inhalation can cause fatal allergic asthma attacks. The detection of findings in lung tissue following hair spray inhalation is extremely rare.


  1. Ago M, Ago K, Ogata M (2002) A fatal case of n-butane poisoning after inhaling anti-perspiration aerosol deodorant. Legal Med 4:113–118PubMedCrossRefGoogle Scholar
  2. Althoff H, Cremer U (1989) Aspects of preliminary proceedings according to criminal law against physicians and morphological requirements for fatal aspiration of amniotic fluid. Z Rechtsmed 102:11–23PubMedGoogle Scholar
  3. Bajanowski T, Ott A, Jorch G, Brinkmann B (1996) Frequency and type of aspiration in cases of sudden infant death (SID) in correlation with the body position at the time of discovery. J SIDS Infant Mortal 1:271–279Google Scholar
  4. Balachandra AT, O‘Connor R, Bowden DH (1987) Sudden unexpected death in asthmatics. J Can Soc Forensic Sci 20:227Google Scholar
  5. Banaschak S, Schmidt P, Madea B (2003) Smothering of children older than one year of age – diagnostic significance of morphological findings. Forensic Sci Int 134:163–168PubMedCrossRefGoogle Scholar
  6. Benatar SR (1986) Fatal asthma. N Engl J Med 314:423–427PubMedCrossRefGoogle Scholar
  7. Berger P, Walls AF, Marthan R, Tunon-de-Lara JM (1998) Immunoglobulin E-induced passive sensitization of human airways: an immunohistochemical study. Am J Respir Crit Care Med 157:610–616PubMedCrossRefGoogle Scholar
  8. Bergeson PS, Hinchcliffe WA, Crawford RF, Sorenson MJ, Trump DS (1978) Asphyxia secondary to massive dirt aspiration. J Pediatr 92:506–507PubMedCrossRefGoogle Scholar
  9. Bowen SE, Batis JC, Paez-Martinez N, Cruz SL (2006) A direct comparison of inhalant effects on locomotor activity and schedule-controlled behavior in mice. Exp Clin Psychopharmacol 6:235–247CrossRefGoogle Scholar
  10. Bransilver BR (1970) Massive aspiration in the newborn. Obstet Gynecol 35:608–612PubMedGoogle Scholar
  11. Brinkmann B, Fechner G, Püschel K (1983) Lung histology in aspiration of watery fluids of different osmolarities. Z Rechtsmed 89:267–277PubMedCrossRefGoogle Scholar
  12. Buschmann C, Schulz F, Tsokos M (2011) Fatal aspiration of barium sulfate. Forensic Sci Med Pathol 7:63–64PubMedCrossRefGoogle Scholar
  13. Byard RW, Chivell WC, Gilbert JD (2003) Unusual facial markings and lethal mechanisms in a series of gasoline inhalation deaths. Am J Forensic Med Pathol 24:298–302PubMedCrossRefGoogle Scholar
  14. Byard RW, Gilbert JD, Terlet J (2007) Death associated with volatile substance inhalation – histologic, scanning electron microscopic and energy dispersive X-ray spectral analyses of lung tissue. Forensic Sci Int 171:118–121PubMedCrossRefGoogle Scholar
  15. Carnevale A, Chiarotti M, Giovanni ND (1983) Accidental death by gasoline ingestion. Case report and toxicological study. Am J Forensic Med Pathol 4:153–157PubMedCrossRefGoogle Scholar
  16. Carroll N, Carello S, Cooke C, James A (1996) Airway structure and inflammatory cells in fatal attacks of asthma. Eur Respir J 9:709–715PubMedCrossRefGoogle Scholar
  17. Chajed PN, Malouf MA, Glanville AR (2003) Risk of bleeding associated with transbronchial lung biopsy. Chest 123:2162CrossRefGoogle Scholar
  18. Champ CS, Byard RW (1994) Sudden death in asthma in childhood. Forensic Sci Int 66:117–127PubMedCrossRefGoogle Scholar
  19. Christia-Lotter A, Bartoli C, Piercecchi-Marti MD, Demory D, Pelissier-Alicot AL, Sanvoisin A, Leonetti G (2007) Fatal occupational inhalation of hydrogen sulfide. Forensic Sci Int 169:206–209PubMedCrossRefGoogle Scholar
  20. Copeland AR (1986) Asthmatic deaths in the medical examiner’s population. Forensic Sci Int 31:7–12PubMedCrossRefGoogle Scholar
  21. Costa JJ, Weller PF, Galli SJ (1997) The cells of the allergic response: mast cells, basophils and eosinophils. JAMA 278:1815–1822PubMedCrossRefGoogle Scholar
  22. Da Broi U, Moreschi C (2011) Post-mortem diagnosis of anaphylaxis: a difficult task in forensic medicine. Forensic Sci Int 204:1–5PubMedCrossRefGoogle Scholar
  23. Deixonne B, Baumel H, Mauras Y, Allain P, Robert C, Raffanel C (1983) A case of barium-peritoneum with neurological involvement. Importance of barium determination in biological fluids. J Chir 120:611–613Google Scholar
  24. Dell’Erba A, Vimercati F (1966) Inalacione di liquido amniotico e causa della morte dell prodotto di concedimento. G Med Leg Infortun Tossicol 12:349Google Scholar
  25. Dettmeyer R, Schmidt P, Driever F, Stiel M, Madea B (2003) Letale pulmonale Hämorrhagien als plötzliche und unerwartete Todesursache. 11th Spring Meeting of the German Society of Forensic Medicine, KielGoogle Scholar
  26. Dirnhofer R, Sigrist T (1983) Intra partum death or infanticide? A contribution on intrapartal asphyxia. Z Rechtsmed 91:145–151PubMedCrossRefGoogle Scholar
  27. Downs JC, Milling D, Nichols CA (1995) Suicidal ingestion of barium-sulfide-containing shaving powder. Am J Forensic Med Pathol 16:56–61PubMedCrossRefGoogle Scholar
  28. Dura H, Morar S, Cipăian CR (2015) Chemical suicide by inhalation of hydrogen sulfide in Sibiu County, Romania. Case report and literature review. Rom J Leg Med 23:289–292CrossRefGoogle Scholar
  29. Edston E, van Hage-Hamsten M (2005) Postmortem diagnosis of anaphylaxis. In: Tsokos M (ed) Forensic pathology reviews, vol 3. Humana, Totowa, pp 267–281CrossRefGoogle Scholar
  30. Efron PA, Beierle EA (2003) Pediatric sand aspiration: case report and literature review. Pediatr Surg Int 19:409–412PubMedCrossRefGoogle Scholar
  31. Eisenmenger W, Liebhardt E, Tröger HD (1980) Zwischenfälle bei endoskopischen Eingriffen und ihre Beurteilung aus rechtsmedizinischer Sicht. Beitr Gerichtl Med 38:25–28PubMedGoogle Scholar
  32. Evans DM (1966) Cadmium poisoning. Br Med J 1:173–174CrossRefGoogle Scholar
  33. Farkaš D, Ŝvajdler MM, Fröhlichová L, Ŝprláková J, Iannaccone SF, Szép Z, Nyitrayová O (2015) Unusual lung finding of massive alveolar filling with foamy macrophages in congenital epidermolysis bullosa after amnion fluid aspiration in 15-day-old newborn without any clinical signs of respiratory impairment. Cesk Patol 51:89–93PubMedGoogle Scholar
  34. Fischer H, Kahler J, Megges G, Steiner R (1977) Zur Kasuistik der Ölschlammaspiration. Z Rechtsmed 79:241–244PubMedCrossRefGoogle Scholar
  35. Fracasso T, Schmeling A (2011) Delayed asphyxia due to inhalation injury. Int J Legal Med 125:289–292PubMedCrossRefGoogle Scholar
  36. Fracasso T, Karger B, Vennemann M, Bajanowski T, Golla-Schindler UM, Pfeiffer H (2010) Amniotic fluid aspiration in cases of SIDS. Int J Legal Med 124:113–117PubMedCrossRefGoogle Scholar
  37. Gebbers O, Tetzner C, Burkhardt A (1979) Alveolitis due to hair-spray. Ultrastructural observations in two patients and the results of experimental investigations. Virchows Arch A Pathol Anat Histol 382:323–338PubMedCrossRefGoogle Scholar
  38. Gebbers O, Burkhardt A, Tetzner C, Rüdiger HW, von Wichert P (1980) “Hair-spray lung”. Clinical and morphological findings. Schweiz Med Wochenschr 110:610–615PubMedGoogle Scholar
  39. Gerber MA, Paronetto F, Kochwa S (1971) Immunohistochemical localization of IgE in asthmatic lungs. Am J Pathol 62:339–348PubMedPubMedCentralGoogle Scholar
  40. Glinjongo C, Kiatchaipipat S, Thepcharoenniran S (2004) Severe sand aspiration: a case report with complete recovery. J Med Assoc Thail 87:825–828Google Scholar
  41. Graev M, Fabroni F (1962) Sulla evoluzione dei focolai di aspirazione ematica polmonare. Min Med Leg 82:255Google Scholar
  42. Gross GF, Howard MA (1972) Perforations of the colon from barium enema. Am Surgeon 38:583–585PubMedGoogle Scholar
  43. Gupta BN, Drew RT (1976) The effect of aerosol hair spray inhalation in the hamster. Am Ind Hyg Assoc J 37:357–360PubMedCrossRefGoogle Scholar
  44. Hanson KA, Gilbert JD, James RA, Byard RW (2002) Upper airway occlusion by soil – an unusual cause of death in vehicle accidents. J Clin Forensic Med 9:96–99PubMedCrossRefGoogle Scholar
  45. Hayashi T, Ishida Y, Mizunuma S, Kimura A, Kondo T (2009) Differential diagnosis between freshwater drowning and saltwater drowning based on pulmonary aquaporin-5 expression. Int J Legal Med 123:7–13PubMedCrossRefGoogle Scholar
  46. Hays SR, Fahy JV (2003) The role of mucus in fatal asthma. Am J Med 115:68–69PubMedCrossRefGoogle Scholar
  47. Heinze S, Erbersdobler A, Tsokos M (2010) Cause of death: anaphylaxis. Autopsy findings and additional investigations. Rechtsmedizin 20:282–284CrossRefGoogle Scholar
  48. Hicks LJ, Scanlon M, Bostwick TC, Batten TJ (1990) Death by smothering and its investigation. Am J Forensic Med Pathol 11:291–293PubMedCrossRefGoogle Scholar
  49. Holgate ST, Davies DE (2001) Epithelia desquamation in asthma. Am J Respir Crit Care Med 164:1997CrossRefGoogle Scholar
  50. Howard MO, Bowen SE, Garland EL, Perron BE, Vaughn MG (2011) Inhalant use and inhalant use disorders in the United States. Addict Sci Clin Pract 6:18–31PubMedPubMedCentralGoogle Scholar
  51. Hughes S, Caverly PMA (1988) Heroin inhalation and asthma. BMJ 297:1511–1512PubMedPubMedCentralCrossRefGoogle Scholar
  52. Ikeda N, Yamakawa M, Imai Y, Suzuki T (1989) Sudden infant death from atelectasis due to amniotic fluid aspiration. Am J Forensic Med Pathol 10:340–343PubMedCrossRefGoogle Scholar
  53. Iwadate K, Doy M, Ito Y (2001) Screening of milk aspiration in 105 infant death cases by immunostaining with anti-human alpha-lactalbumin antibody. Forensic Sci Int 122:95–100PubMedCrossRefGoogle Scholar
  54. Janssen W (1977) Forensische Histologie. Schmidt-Roemhild, Lübeck, pp 207–210Google Scholar
  55. Janssen W (1984) Pregnancy, abortion, aborticide. The problem of the cause of death. In: Janssen W (ed) Forensic histopathology. Springer, Berlin, pp 205–207CrossRefGoogle Scholar
  56. Jedidi M, Bel Hadj M, Masmoudi T, Ben Adelkarim S, Mlayeh S, Ben Dhiab M, Souguir MK (2016) Fatal toxic myocarditis induced by paraphenylene diamine. A case report. Rom J Led Med 24:17–20CrossRefGoogle Scholar
  57. Jobba G (1971) Nachweis von aspiriertem Amylum und Cellulose mit der modifizierten Steinschen Reaktion. Z Rechtsmed 68:204–206PubMedCrossRefGoogle Scholar
  58. Kaelan C, Harper C, Vieira BI (1986) Acute encephalopathy and death due to petrol sniffing: neuropathological findings. Aust NZ J Med 16:804–807CrossRefGoogle Scholar
  59. Kawajiri T, Nagata N, Morimoto Y, Ishimatsu S, Hori H, Tanaka I, Yatera K, Yoshii C, Kido M (2004) Pathology and mechanism of lung toxicity following inhalation of hair spray in rats. Inhal Toxicol 16:147–153PubMedCrossRefGoogle Scholar
  60. Kearney MS (1999) Chronic intrauterine meconium aspiration cause fetal lung infarcts, lung rupture, and meconium embolism. Pediatr Dev Pathol 2:544–551PubMedCrossRefGoogle Scholar
  61. Keating WR, Hayward MG (1981) Sudden death in cold water and ventricular arrhythmia. J Forensic Sci 26:451–461Google Scholar
  62. Kettner M, Ramsthaler F, Horlebein B, Schmidt PH (2008) Fatal outcome of a sand aspiration. Int J Legal Med 122:499–502PubMedCrossRefGoogle Scholar
  63. Klitte A, Gilbert JD, Lokan R, Byard RW (2002) Adolescent suicide due to inhalation of insect spray. J Clin Forensic Med 9:22–24PubMedCrossRefGoogle Scholar
  64. Koops E, Püschel K, Hadjiraftis K, Brinkmann B (1983) Ungewöhnliche Aspirations-Todesfälle. Beitr Berichtl Med 42:47–56Google Scholar
  65. Krantz AJ, Hershow RC, Prachand N, Hayden DM, Franklin C, Hryhorczuk DO (2003) Heroin insufflation as a trigger for patients with life threatening asthma. Chest 1213:510–517CrossRefGoogle Scholar
  66. Lang J, Felske-Zech H, Veit F, Lasczkowski G, Dettmeyer R (2015) Chronic abuse of hairspray by inhalation and sudden death of a 20-year-old woman. Rom J Leg Med 23:285–288CrossRefGoogle Scholar
  67. Le Breton R, Bourtris L, Garat J (1963) Un cas d’ empoisonnement criminel par le trichlorethylene. Ann Med leg 43:281–283Google Scholar
  68. Lenler-Petersen P, Hansen D, Andersen M (1995) Drug-related fatal anaphylactic shock in Denmark 1968–1990. A study based on notifications to the committee on adverse drug reactions. J Clin Epidemiol 48:1185–1188PubMedCrossRefGoogle Scholar
  69. Leopold D (1959) Blutaspirationen bei Dekapitationen. Zeitschr ärztl Fortb 53:1043–1045Google Scholar
  70. Leslie KO (2009) My approach to interstitial lung disease using clinical, radiological and histopathological patterns. J Clin Pathol 62:387–401PubMedPubMedCentralCrossRefGoogle Scholar
  71. Lewis JW Jr, Kerstein MD, Koss N (1975) Barium granuloma of the rectum: an uncommon complication of barium enema. Ann Surg 181:418–423PubMedPubMedCentralCrossRefGoogle Scholar
  72. Liang M, Sunnassee A, Yan L, Zheng N, Zhuo L, Haidong Z, Liang L (2010) Fatal anaphylaxis in the presence of eosinophilic pneumonia in an asthmatic patient. A case report. Rom J Leg Med 18:193–198CrossRefGoogle Scholar
  73. Linch CA, Prahlow JA (2008) Microscopical examination of particles on smoked cigarette filters. Forensic Sci Med Pathol 4:228–233PubMedCrossRefGoogle Scholar
  74. Maebashi K, Iwadate K, Sakai K, Takatsu A, Fukui K et al (2011) Toxicological analysis of 17 autopsy cases of hydrogen sulfide poisoning resulting from the inhalation of intentionally generated hydrogen sulfide gas. Forensic Sci Int 207:91–95PubMedCrossRefGoogle Scholar
  75. Maxeiner H, Schneider V (1985) Death by suffocation as a result of occlusion of the respiratory tract by sand. Z Rechtsmed 94:173–189PubMedGoogle Scholar
  76. Modell JH, Bellefleur M, Davis JH (1999) Drowning without aspiration: is this an appropriate diagnosis? J Forensic Sci 44:1119–1123PubMedCrossRefGoogle Scholar
  77. Morild I, Giertsen JC (1989) Sudden death from asthma. Forensic Sci Int 42:145–150PubMedCrossRefGoogle Scholar
  78. Morita S, Furukawa S, Wingenfeld L, Nishi K (2013) Expression of antigens related to hypoxia, stress, and apoptosis in the myocardium after fatal carbon exposure. Rom J Leg Med 21:253–258CrossRefGoogle Scholar
  79. Mueller B, Erbach A, Ottmar U (1960) Studien über das Schicksal von Blutaspirationsherden. Riv Med Leg Legislac Sanit 2:7Google Scholar
  80. Nagata N, Kawajiri T, Hayashi T, Nakanishi K, Nikaido Y, Kido M (1997) Interstitial pneumonitis and fibrosis associated with the inhalation of hair spray. Respiration 64:310–312PubMedCrossRefGoogle Scholar
  81. Nishio H, Takai S, Miyazaki M, Horiuchi H, Osawa M, Uemura K (2005) Usefulness of serum mast cell-specific chymase levels for post-mortem diagnosis of anaphylaxis. Int J Legal Med 119:331–334PubMedCrossRefGoogle Scholar
  82. Oehmichen M (1984) Blutabbau in den Lungenaleolen: Zeichen der Vitalität und Bestimmung der Überlebenszeit. Z Rechtsmed 92:47–57CrossRefPubMedGoogle Scholar
  83. Ordonez C, Ferrando R, Hyde DM, Wong HH, Fahy JV (2000) Epithelial desquamation in asthma: artifact or pathology? Am J Respir Crit Care Med 162:2324–2329PubMedCrossRefGoogle Scholar
  84. Ortmann C, Fechner G, Schmäl F (2000) Akuter Tod nach Halsschmerzen. 9th Spring Meeting of the German Society of Forensic Medicine. 4–5 May, LeipzigGoogle Scholar
  85. Ortmann C, Wüllenweber J, Brinkmann B, Fracasso T (2010) Fatal mycotic aneurysm caused by Pseudallescheria boydii after near drowning. Int J Legal Med 124:243–247PubMedCrossRefGoogle Scholar
  86. Paterson JC (1947) Studies on the toxicity of inhaled cadmium. J Ind Hyg Toxicol 29:294–301PubMedGoogle Scholar
  87. Pelissier-Alicot AL, Leonetti G, Champsaur P, Allain P, Mauras Y, Botta A (1999) Fatal poisoning due to intravasation after oral administration of barium sulfate for contrast radiography. Forensic Sci Int 106:109–113PubMedCrossRefGoogle Scholar
  88. Pentillä A (1980) Sudden and unexpected natural deaths of adult males. Forensic Sci Int 16:249–259CrossRefGoogle Scholar
  89. Perskvist N, Edston E (2007) Differential accumulation of pulmonary and cardiac mast cell-subsets and eosinophils between fatal anaphylaxis and asthma death. A post-mortem comparative study. Forensic Sci Int 169:43–49PubMedCrossRefGoogle Scholar
  90. Peters WJ (1981) Inhalation injury caused by the products of combustion. Can Med Assoc J 125:249–252PubMedPubMedCentralGoogle Scholar
  91. Pfeiffer H, Al Khaddam M, Brinkmann B, Köhler H, Beike J (2006) Sudden death after isobutene sniffing: a report of two forensic cases. Int J Legal Med 120:168–173PubMedCrossRefGoogle Scholar
  92. Preston HV, Bowen DAL (1987) Asthma deaths: a review. Med Sci Law 27:89–94PubMedCrossRefGoogle Scholar
  93. Preuss J, Dettmeyer R, Madea B (2005) Tödliche Blutungskomplikation durch Pulmonalarterienwandruptur bei Rechtsherzkatheter. 84 Annual Meeting of the German Society of Forensic Medicine, 19–24 September, HamburgGoogle Scholar
  94. Pumphrey RSH, Roberts ISD (2000) Postmortem findings after anaphylactic reactions. J Clin Pathol 53:273–276PubMedPubMedCentralCrossRefGoogle Scholar
  95. Rabl W, Ambach E, Battista H (1989) Hautschädigung bei tödlicher Benzindampfinhalation. Beitr Gerichtl Med 47:295–300PubMedGoogle Scholar
  96. Rainbow J, Browne GJ (2002) Fatal asthma or anaphylaxis? Emerg Med J 19:415–417PubMedPubMedCentralCrossRefGoogle Scholar
  97. Reedy SJ, Schwarz MD, Morgan BW (2011) Suicide fads: frequency and characteristics of hydrogen sulfide suicides in the United States. West J Emerg Med 12:300–304PubMedPubMedCentralGoogle Scholar
  98. Reiter C (1985) Rauchverhalten und Zytologie der Raucherzellen. Z Rechtsmed 95:167–173PubMedCrossRefGoogle Scholar
  99. Revenstorf V (1904) Der Nachweis der aspirierten Ertrinkungsflüssigkeit als Kriterium des Todes durch Ertrinken. Vjschr Gerichtl Med 27:274Google Scholar
  100. Robin ED, Lewiston N (1989) Unexpected, unexplained sudden death in young asthmatic subjects. Chest 96:790–793PubMedCrossRefGoogle Scholar
  101. Rohrig T (1997) Sudden death due to butane inhalation. Am J Forensic Med Pathol 18:299–302PubMedCrossRefGoogle Scholar
  102. Sakai K, Maruyama-Maebashi K, Takatsu A, Fukui K, Nagai T, Aoyagi M, Ochiai E, Iwadate K (2011) Sudden death involving inhalation of 1,1-difluoroethane (HFC-152a) with spray cleaner: three case reports. Forensic Sci Int 206:e58–e61PubMedCrossRefGoogle Scholar
  103. Särkioja T, Hirvonen J (1984) Causes of sudden unexpected deaths in young and middle-aged persons. Forensic Sci Int 24:247–261PubMedCrossRefGoogle Scholar
  104. Sato H, Tanaka T, Kasai K, Kita T, Tanaka N (2009) Perforation of the trachea by an endotracheal tube: an autopsy case. Int J Legal Med 123:513–516PubMedCrossRefGoogle Scholar
  105. Saukko P, Knight B (2004) Immersion deaths. In: Saukko P, Knight B (eds) Knight’s forensic pathology. Arnold, London, pp 395–411Google Scholar
  106. Schmeling A, Fracasso T, Pragst F, Tsokos M, Wirth I (2009) Unassisted smothering in a pillow. Int J Legal Med 123:517–519CrossRefPubMedGoogle Scholar
  107. Schmidt U, Günzel A, Müller L, Thiele K (2003) Plötzlicher Tod eines Kleinkindes durch Mageninhaltsaspiration bei Norwalk-like-Virusinfektion. 82nd Annual Meeting, German Society of Forensic Medicine. 17–20 September, MünsterGoogle Scholar
  108. Schrot M, Schulz F, Andresen H, Püschel K, Römhild W, Szibor R (2009) Forensische Pädopathologie: Tod durch Lösungsmittelinhalation – “Schnüffeltod”. Päd 15:35–40Google Scholar
  109. Segal E, Wason S (1990) Sudden death by inhalation of butane and propane. N Engl J Med 323:1638Google Scholar
  110. Shaikh WA (1990) Allergy to heroin. Allergy 45:555–556PubMedCrossRefGoogle Scholar
  111. Shepherd RT (1989) Mechanism of sudden death associated with volatile substance abuse. Hum Toxicol 8:287–291PubMedCrossRefGoogle Scholar
  112. Shiang C, Mauad T, Senhorini A, de Araúja BB, Ferreira DS, da Silva LF, Dohlnikoff M, Tsokos M, Rabe KF, Pabst R (2009) Pulmonary periarterial inflammation in fatal asthma. Clin Exp Allergy 39:1450–1452CrossRefGoogle Scholar
  113. Sinicina I, Pankratz H, Bise K, Metevossian E (2009) Forensic aspects of post-mortem histological detection of amniotic fluid embolism. Int J Legal Med 124:55–62PubMedCrossRefGoogle Scholar
  114. Smith LT, Miller AW, Kirz DA, Elias S, Brumbaugh S, Holbrook KA (1992) Separation of noncutaneous epithelia in a fetus diagnosed in utero with junctional epidermolysis bullosa. Pediatr Res 31:561–566PubMedCrossRefGoogle Scholar
  115. Spendlove D, Trübner K, Bajanowski T (2007) Perforation of the pulmonary artery by a bronchial wall stent. Int J Legal Med 121:204–206PubMedCrossRefGoogle Scholar
  116. Strange C, Heffner JE, Collins BS, Brown FM, Sahn SA (1987) Pulmonary hemorrhage and air embolism complicating transbronchial biopsy in pulmonary amyloidosis. Chest 92:367–369PubMedCrossRefGoogle Scholar
  117. Sugie H, Sasaki C, Hashimoto C, Takeshita H, Nagai T, Nakamura S, Furukawa M, Nishikawa T, Kurihara K (2004) Three cases of sudden death due to butane or propane gas inhalation: analysis of tissues for gas components. Forensic Sci Int 143:211–214PubMedCrossRefGoogle Scholar
  118. Suzuki T, Ikeda N, Umetsu K, Kashimura S (1985) Swimming and loss of consciousness. Z Rechtsmed 94:121–126PubMedGoogle Scholar
  119. Townshead RH (1968) A case of acute cadmium pneumonitis: lung function tests during a four-year-follow-up. Br J Ind Med 25:68–71Google Scholar
  120. Trikha S, Jatav OP, Rastogi P, Kansal A et al (2013) A case of myocarditis mimicking myocardial infarction in hair dye poisoning. J Ind Coll Cardiol 3:173–176Google Scholar
  121. Tsokos M (2006) Asthma deaths. Phenomenology, pathology and medicolegal aspects. In: Tsokos M (ed) Forensic pathology reviews, vol 4. Humana Press Inc., Totwa, NJ, pp 107–141CrossRefGoogle Scholar
  122. Tsokos M, Byard RW (2007) Massive, fatal aspiration of blood: not necessarily a result of trauma. Am J Forensic Med Pathol 28:53–54PubMedCrossRefGoogle Scholar
  123. Tsokos M, Paulsen F (2002) Expression of pulmonary lactoferrin in sudden-onset and slow-onset asthma with fatal outcome. Virchows Arch 441:494–499PubMedCrossRefGoogle Scholar
  124. Tsokos M, Schulz F, Vogel H (1998) Barium aspiration with fatal outcome. Aktuelle Radiol 8:201–203PubMedGoogle Scholar
  125. Uchida K, Unuma K, Uemura K (2015) A fatality in a child with severe fatty liver due to n-butane and isopentane poisoning resulting from long-term inhalation of an antiperspirant aerosol. Forensic Sci Med Pathol 11:631–632PubMedCrossRefGoogle Scholar
  126. Unkrig S, Hagemeier L, Madea B (2010) Postmortem diagnostics of assumed food anaphylaxis in an unexpected death. Forensic Sci Int 198:e1–e4PubMedCrossRefGoogle Scholar
  127. Vally H, Thompson PJ (2003) Allergic and asthmatic reactions to alcoholic drinks. Addict Biol 8:3–11PubMedCrossRefGoogle Scholar
  128. von Lüpke H, Gerchow J, Schmidt K (1978) Über zwei Fälle von tödlicher Trichloräthylenvergiftung. Z Rechtsmed 81:237–241CrossRefGoogle Scholar
  129. Walcher K (1930) Über Aspiration und Verschlucken von Gehirnstücken als Zeichen intravitaler Entstehung schwerer Verletzungen. Z Rechtsmed 15:398–406CrossRefGoogle Scholar
  130. Wales J, Jackimczyk K, Rosen P (1983) Aspiration following a cave-in. Ann Emerg Med 12:99–101PubMedCrossRefGoogle Scholar
  131. Wehner F, Benz D, Wehner HD (2002) Tödiche Inhalation von Butan-Propan-Gas. Arch Kriminol 209:165–168Google Scholar
  132. Wick R, Gilbert JD, Felgate P, Byard RW (2007) Inhalant deaths in South Australia – a 20-year retrospective autopsy study. Am J Forensic Med Pathol 28:319–322PubMedCrossRefGoogle Scholar
  133. Wright JL, Cockcroft DW (1981) Lung diseases due to abuse of hairspray. Arch Pathol Lab Med 105:363–366PubMedGoogle Scholar
  134. Yamamoto K, Ueda M, Kikuchi H, Hattori H, Hiraoka Y (1983) An acute fatal occupational cadmium poisoning by inhalation. Z Rechtsmed 91:139–143PubMedCrossRefGoogle Scholar
  135. Yen K, Plattner T, Dirnhofer R (2005) Retrograde blood aspiration: a vital reaction. Forensic Sci Int 154:13–18PubMedCrossRefGoogle Scholar
  136. Zhang L, Yang Y, Zhang J, Zhou X, Dong H, Zhou Y (2015) Barium sulfate aspiration: severe chemical pneumonia induced by a massive reflux of contrast medium during small bowel barium enema. Forensic Sci Int 253:e16–e19PubMedCrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Reinhard B. Dettmeyer
    • 1
  1. 1.University Hospital Giessen Institute of Forensic MedicineGiessenGermany

Personalised recommendations