Red velvety appearance of stomach mucosa is seen in the poisoning of:
Ref: The Essentials of Forensic Medicine and Toxicology by KS Narayan Reddy, 29th edition, 2010, Page 452Explanation:"Arsenic Poisoning: The lesions are mainly found in the stomach. The mucosa is swollen, oedematous and red either generally or in patches; especially in the pyloric region. There may be lines of redness running along the wails or curved lines of submucous haemorrhages. The stomach mucosa resembles red velvet." (Ref: KS Narayan Reddy)ARSENIC POISONINGInterferes with cellular respiration by combining with the sulphvdryl groups of mitochondrial enzymes.Affects pyruvate oxidase and phosphatases. Clinical FeaturesSweet metallic taste.Burning colicky abdominal pain.Purging.Tenesmus.Stools are bloody dark coloured, foul smelling.Stools become colourless and odourless in late stages (Rice watery stool).Garlicky odour of breath and faeces.Other FeaturesFatty liver.Nephritis.Increased vascular permeability.Ventricular tachycardia.Ventricular fibrillation.Peripheral neuropathy - Stocking glove distribution.Fatal dose: 0.1 - 0.2 Arsenic trioxide.Fatal period: 1 - 2 days.TreatmentEmetics are not recommended.Stomach wash with warm water and milk.Freshly prepared hydrated ferric oxide: Converts toxic arsenic to nontoxic ferric oxide.BAL.Penicillamine.DMSA.Castor oil or magnesium sulphate decreases intestinal absorption.Postmortem Appearance:Raindrop type of skin pigmentation.Aldrich Mees lines in nails.Red velvety stomach mucosa.COPPER POISONINGAsa metal is not poisonous.Copper compounds are powerful inhibitors ofenzymes.Poisonous compounds:o Copper sulphate (Blue vitriol) o Copper subacetate (Verdigris).Clinical FeaturesMetallic taste.T Salivation.Blue vomitusDiarrhea.Uremia, hematuria.Acidosis.Hemoglobinuria.Jaundice.Pancreatitis.Altered sensorium.Weakness.Coma.Fatal Dose:Copper sulphate-30 grams.Copper subacetate-15 grams.Fatal Period: 1-3 days.TreatmentStomach wash with 1% potassium ferrocyanide.Hemodialysis useful in early stages.Castor oil removes copper from intestine.Chelation with penicillamine/EDTA/BAL.Postmortem AppearanceGastric mucosa and stomach contents: Bluish or greenish.Other CharacteristicsChronic poisoning: Chalcosis - Presence of copper deposits in tissues.MERCURY POISONINGAcid metallic taste.Hoarse voice.Greyish white coating of tongue.B lood- stai ned stool.Circulatory collapse.Necrosis of jaw.Membranous.Colitis.Proximal renal tubular necrosis.o Acrodyniat Aero-Limbs Odynia-Pain) is seen in mercury poisoning (aka Pink's Disease ). It is characterized by pain, swelling and parasthesia of limbso Mimimata disease--Contamination of fish with mercury, at a place called Minimate Bay in Japan.o Chronic Poisoning (Hydrargyrism): The symptoms are salivation, sore mouth and throat, fine tremors of the tongue, hands, arms, anemia.o Shaking palsy is associated with Hg poisoning. Mercurial tremors are also called hatter's shakes or glass blower's shake or Danbury tremors.o Mercurial erethism is seen in persons working with mercury in mirror manufacturing firms. Erethism is characterized by shyness, timidity, irritability, loss of confidence, mental depression, loss of memory and insomnia (Psychological symptoms).o Mercuria lentis is a peculiar eye change due to brownish deposit of mercury through the cornea on the anterior lens capsule (Brown- Malt Reflex). It is bilateral and has no effect on visual acuity.
Lead
Arsenic
Copper
Mercury
Forensic Toxicology - Concepts, Statutes, Evidence, and Techniques