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Medicina Legal de Costa Rica

On-line version ISSN 2215-5287Print version ISSN 1409-0015


VILLALOBOS VARGAS, Katherine  and  CHACON BARQUERO, Lawrence. Sudden death by alcoholic ketoacidosis in chronic alcoholics: report of 3 cases. Med. leg. Costa Rica [online]. 2021, vol.38, n.1, pp.46-53. ISSN 2215-5287.

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).

Keywords : Alcoholic ketoacidosis; ketone bodies; beta-hydroxybutyrate; chronic alcoholism; death cause; autopsy; forensic pathology.

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