2009
DOI: 10.1007/s00414-009-0344-9
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Forensic application of ESEM and XRF-EDS techniques to a fatal case of sodium phosphate enema intoxication

Abstract: Sodium phosphate enemas and laxatives are widely used for the treatment of constipation, even if a number of cases of significant toxicity due to alterations of the fluid and electrolyte equilibria (hypernatremia, hyperphosphatemia, and hypocalcemia) have been reported. We present the case of an 83-year-old man who died of fecal and chemical peritonitis secondary to an iatrogenic colon perforation (produced performing a Fleet enema through the patient's iliac colostomy) with peritoneal absorption of sodium pho… Show more

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Cited by 16 publications
(8 citation statements)
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“…First, micro-CT analysis gives an indirect identification of GSR particles; thereby, substances with the same density of powder particles might be erroneously tagged as GSR, generating a false positive result. Considering that micro-CT is a non-destructive technique [20], a possible solution for the above-mentioned problem could be the identification of the chemical composition of the metal residues by means of an environmental scanning electron microscope coupled to an X-ray fluorescence energy dispersive spectroscope [28], thus strongly reducing the possibility of a misinterpretation of the results.…”
Section: Resultsmentioning
confidence: 99%
“…First, micro-CT analysis gives an indirect identification of GSR particles; thereby, substances with the same density of powder particles might be erroneously tagged as GSR, generating a false positive result. Considering that micro-CT is a non-destructive technique [20], a possible solution for the above-mentioned problem could be the identification of the chemical composition of the metal residues by means of an environmental scanning electron microscope coupled to an X-ray fluorescence energy dispersive spectroscope [28], thus strongly reducing the possibility of a misinterpretation of the results.…”
Section: Resultsmentioning
confidence: 99%
“…However, this theory seems less plausible, given the consistent absence of any signs of granuloma or cell reactions. Scanning electron microscope in association with energy dispersion spectrometry has recently been used in forensic medicine in different areas like gunshot residue analysis [25][26][27], dental comparison [28], diagnosis of work-related pulmonary diseases (silica particles) [29] and evidence of exogenous substances (sodium phosphate) [30].…”
Section: Discussionmentioning
confidence: 99%
“…Obviously, considering that microCT is a nondestructive technique and that the proposed method allows only a presumptive identification of the GSR particles, positive results should be confirmed with a "gold standard" method such as environmental scanning electron microscopy coupled with an X-ray fluorescence energy dispersive spectrometry [26,27], ICP-MS [15,16] or neutron activation analysis [17].…”
Section: Discussionmentioning
confidence: 99%