Lack of gastric emptying at autopsy eleven days after heat trauma in the sauna- a forensic autopsy case report

A man in his mid-70s passed out in a public 90-degree sauna and remained unconscious for at least half an hour. He suffered third-degree burns to approximately 50% of his body surface area. Despite immediate transport to a burn center and intensive care therapy, he did not regain consciousness and died eleven days later.When the body was opened, the lungs, liver, kidneys, and spleen showed changes consistent with the burns, intensive care therapy, and clinically suspected septic shock. The stomach contained approximately 200 ml of thickened chyme with coarse vegetable components. Such food components were not seen in the duodenum or in the following intestinal segments.Considering the overall circumstances, the stomach contents must have been the last meal the man had eaten before the sauna session. The problem of reduced gastrointestinal motility in burn patients is clinically recognized. Nevertheless, a complete failure of gastric emptying for eleven days after intensive care therapy has not been described before and shows that the use of gastric contents in forensic practice is inappropriate for drawing conclusions about the time interval between last food intake and death and thus for estimating the time of death.