<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1409-0015</journal-id>
<journal-title><![CDATA[Medicina Legal de Costa Rica]]></journal-title>
<abbrev-journal-title><![CDATA[Med. leg. Costa Rica]]></abbrev-journal-title>
<issn>1409-0015</issn>
<publisher>
<publisher-name><![CDATA[Asociación Costarricense de Medicina Forense]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1409-00152021000100046</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Muerte súbita por cetoacidosis alcohólica en etilistas crónicos: reporte de 3 casos]]></article-title>
<article-title xml:lang="en"><![CDATA[Sudden death by alcoholic ketoacidosis in chronic alcoholics: report of 3 cases]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Villalobos Vargas]]></surname>
<given-names><![CDATA[Katherine]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Chacón Barquero]]></surname>
<given-names><![CDATA[Lawrence]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad de Costa Rica Poder Judicial Departamento de Medicina Legal]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Costa Rica</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Poder Judicial Departamento de Medicina Legal ]]></institution>
<addr-line><![CDATA[Heredia ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2021</year>
</pub-date>
<volume>38</volume>
<numero>1</numero>
<fpage>46</fpage>
<lpage>53</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S1409-00152021000100046&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S1409-00152021000100046&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S1409-00152021000100046&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen En Patología Forense es común estudiar cadáveres de individuos con antecedente de alcoholismo crónico, que son encontrados fallecidos y cuyo deceso no fue presenciado; por lo que en gran cantidad de autopsias la determinación de la causa de muerte es compleja. La cetoacidosis alcohólica constituye un síndrome complejo derivado de una alteración del metabolismo en el contexto de un consumo excesivo de alcohol e ingesta calórica insuficiente. Se trata de un diagnóstico diferencial importante como causa de muerte en alcohólicos crónicos que fallecen posterior a un ayuno de algunos días, secundario a molestias abdominales como gastritis inducida por etanol, usualmente asociada a vómitos. Clínicamente estas personas presentan además dolor abdominal, taquicardia y alteraciones respiratorias. El diagnóstico postmortem se confirma mediante la presencia de cuerpos cetónicos, especialmente beta-hidroxibutirato, en sangre, humor vítreo u orina. A continuación se presentan tres casos de muerte súbita por cetoacidosis alcohólica con historia de abuso crónico de bebidas etílicas; se discute su fisiopatología, hallazgos al momento de la autopsia y resultados de exámenes complementarios (análisis toxicológico y estudio histopatológico).]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract In the forensic pathology setting, it is frequent to study corpses of individuals that were known to be chronic alcoholics and suffered a sudden death. Therefore, many autopsies are performed, in which determining the cause of death is a complex task. Alcoholic ketoacidosis refers to a complex syndrome derived from a metabolic disarrangement, related to excessive consumption of alcohol and an insufficient caloric intake. It is an important diagnosis that should be considered in sudden deaths of chronic alcoholics with a recent history of fasting, due to abdominal complains such as gastritis induced by alcohol and usually associated with recurrent vomiting. Clinically these patients present with abdominal pain, tachycardia and respiratory anomalies. The diagnosis can be confirmed when elevated ketone bodies, especially beta-hydroxybutyrate, are found in blood, vitreous humour or urine. In this paper we present three cases of sudden death by alcoholic ketoacidosis with a history of chronic abuse of alcohol, discussing it´s pathophysiology, autopsy findings and the results of additional studies (toxicologic screening and histopathology).]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cetoacidosis alcohólica]]></kwd>
<kwd lng="es"><![CDATA[cuerpos cetónicos]]></kwd>
<kwd lng="es"><![CDATA[beta-hidroxibutirato]]></kwd>
<kwd lng="es"><![CDATA[alcoholismo crónico]]></kwd>
<kwd lng="es"><![CDATA[causa muerte]]></kwd>
<kwd lng="es"><![CDATA[autopsia]]></kwd>
<kwd lng="es"><![CDATA[patología forense.]]></kwd>
<kwd lng="en"><![CDATA[Alcoholic ketoacidosis]]></kwd>
<kwd lng="en"><![CDATA[ketone bodies]]></kwd>
<kwd lng="en"><![CDATA[beta-hydroxybutyrate]]></kwd>
<kwd lng="en"><![CDATA[chronic alcoholism]]></kwd>
<kwd lng="en"><![CDATA[death cause]]></kwd>
<kwd lng="en"><![CDATA[autopsy]]></kwd>
<kwd lng="en"><![CDATA[forensic pathology]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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