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Olanzapine‐Induced Fatal Ketoacidosis with Pneumomediastinum and Subcutaneous Emphysema
Author(s) -
Torimitsu Suguru,
Makino Yohsuke,
Saka Kanju,
Fujii Yusuke,
Abe Hiroko,
Chiba Fumiko,
Yamaguchi Rutsuko,
Iwase Hirotaro
Publication year - 2019
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.13942
Subject(s) - pneumomediastinum , subcutaneous emphysema , medicine , autopsy , diabetic ketoacidosis , olanzapine , ketoacidosis , anesthesia , forensic pathology , putrefaction , surgery , pathology , pneumothorax , diabetes mellitus , schizophrenia (object oriented programming) , endocrinology , psychiatry , type 1 diabetes , archaeology , history
We report a case of fatal olanzapine‐induced ketoacidosis in which pneumomediastinum ( PM ) and subcutaneous emphysema ( SE ) were detected on postmortem computed tomographic ( CT ) images. A man in his forties was found in a state of cardiopulmonary arrest with profuse perspiration, and 50 empty capsules of olanzapine (10 mg) and flunitrazepam (1 mg) were found in his room. The major findings of postmortem CT prior to autopsy were PM and SE from the lower half of the face to the height of the first rib. The results of autopsy, biochemical tests, and toxicological analyses indicated the cause of death to be fatal ketoacidosis induced by olanzapine intoxication. No injuries, medical interventions, or particular diseases were evident, suggesting that PM and SE were caused by ketoacidosis. Our findings indicated that toxicological analyses should be performed when PM and SE are detected on CT images.