ISSN: 2469-2794 FRCIJ

Forensic Research & Criminology International Journal
Mini Review
Volume 1 Issue 1 - 2015
Postmortem Urine Volume: How Hard-Pressed Medicolegal Examiner Labs Can Use a Simple Test to Help Screen for Alcohol/Drugs
James Gregory Wigmore*
Forensic Alcohol Toxicologist, Canada
Received: June 17, 2015 | Published: June 30, 2015
*Corresponding author: James Gregory Wigmore, Forensic Alcohol Toxicologist, 283 Danforth Ave, Suite 517, Toronto, Ontario, M4K, 1N2, Canada, Fax: (416) 406-6141; Email:
Citation: Wigmore JG (2015) Postmortem Urine Volume: How Hard-Pressed Medicolegal Examiner Labs Can Use a Simple Test to Help Screen for Alcohol/Drugs. Forensic Res Criminol Int J 1(1): 00003. DOI: 10.15406/frcij.2015.01.00003

Introduction

In an ideal world, all unexplained deaths would have a complete alcohol/drug screen conducted. With tight government budgets, however, this is not possible and medciolegal examiner toxicology laboratories have to make difficult choices. Now, new research has helped make those choices easier.

Postmortem Bladder Urine Volume as an Indicator of Alcohol/Drug Intoxication

It has been a frequent observation by forensic pathologists that postmortem urinary bladder distension has been associated with intoxication of the deceased. But there has been no published study confirming this observation until now. Rohner et al [1] determined the bladder urine volume physically in 259 autopsy cases by the pathologist and were compared to the non-invasive computed tomography (CT) result. Both the measured urine volume and CT estimated urine volume compared favorably with a mean difference of only 0.8 mL. The following table shows themean measured urine volume in the deceased according to type of case (Table 1).

Case Type

Mean Urine
Volume (mL)

Not intoxicated

92

Intoxicated

215

Alcohol Positive

217

Non Fatal Intoxication

161

Fatal Intoxication

255

Opiate. Methadone Positive

222

Cocaine Positive

321

Table 1: Mean urine volume (mL) according to type of postmortem case. (Note: 30 mL = approximately 1 fld oz.).

The study determined that if a urinary bladder volume cutoff of 182 mL was employed that there was a 40% sensitivity and 87% specificity of detecting of detecting drug/alcohol intoxication. If a higher urine volume cutoff of 330 mL was used, there was a decrease in sensitivity or detecting alcohol/drug intoxication to 25% but the specificity increased to 97%.

The authors commented; “This means that the occurrence of urinary bladder distension as a single finding on post-mortem imaging should raise suspicion of intoxication and result in subsequent toxicological analyses”.

Conclusion

This recent study has confirmed the old lore that postmortem urinary bladder distension is a sign of alcohol/drug intoxication of the deceased. Postmortem urine volume may provide a new preliminary screening test for the busy pathologist, coroner, medicolegal examiner or toxicologist. It also may detect cases in which there was no suspicion of alcohol/drug intoxication. Of course drug/alcohol screening choices should not be based on urine volume alone and more research should be conducted in this area.

References

  1. Rohner C, Franckenberg S, Schwendener N, Oestreich A, Kraemer T, et al. (2013) New evidence for old lore-urinary bladder distension on post-mortem computed tomography is related to intoxication. Forensic Sci Int 225(1-3): 48-52.
© 2014-2016 MedCrave Group, All rights reserved. No part of this content may be reproduced or transmitted in any form or by any means as per the standard guidelines of fair use.
Creative Commons License Open Access by MedCrave Group is licensed under a Creative Commons Attribution 4.0 International License.
Based on a work at http://medcraveonline.com
Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version | Opera |Privacy Policy