Gastric Contents

The description of stomach contents has been used to estimate the time of death, if the time, volume, and character of the individual's last meal are known (68-70). On occasion, if pills are not digested, stomach contents provide a clue to a toxicological cause of death (Fig. 38; ref. 68). The investigator may request that the pathologist examine the stomach, particularly if other postmortem parameters were not recorded during the initial examination of the body at the scene.

Documentation of the type of food, its volume, and state of digestion is done at autopsy. One assumption is that if the contents are recognizable and distinctive, then a

Fig. 37. Adipocere encasing long bone.
Fig. 38. Stomach opened at autopsy. In most cases, medications will have dissolved in the stomach by the time of death. The finding of an excess number of pills supports intentional ingestion.

similar meal has not been eaten in the interim. Simultaneously ingested liquid, digestible solid, and nondigestible solid foods are emptied from the stomach at different rates (69). Liquids are emptied rapidly (68-70). Another assumption is that digestion and gastric emptying proceed at regular rates. Meals of high volume and caloric content are emptied more slowly (e.g., light meal, 2 h; medium-sized meals, 3-4 h; heavy meals, 4-6 h), but digestion of various foods is variable and continues after death (5,68,69,71,72). Some foodstuffs (e.g., fibrous vegetables) are more resistant to digestion and persist in the stomach (72). Larger pieces of less-chewed food are digested more slowly and remain in the stomach longer (71-73). Gastric emptying varies in the same individual and between individuals under similar circumstances eating the same meal (69). Gastric emptying is affected by many factors. Some factors delaying emptying include trauma, shock, disease, increased intracranial pressure owing to head injury, emotional upset, ethanol, and other drugs (e.g., narcotic analgesics; refs. 68,70-72). Severe trauma can delay emptying up to several days (70). Stomach contents are rarely useful in estimating the time of death because of the many variables involved (68,69,71,74).

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