In a case of suspected chronic ethanol dependence, forensic determination of whether alcohol was consumed shortly before death (vs. postmortem alcohol formation) is BEST established by which finding?
- A Vitreous alcohol concentration less than blood alcohol concentration
- B Vitreous alcohol concentration greater than or equal to blood alcohol concentration with positive vitreous ethanol in the absence of putrefaction ✓
- C Urinary alcohol concentration equal to blood alcohol concentration
- D Presence of methanol rather than ethanol in postmortem blood
Explanation
Distinguishing antemortem ethanol consumption from postmortem production (PME) is a major forensic challenge. PME occurs through microbial fermentation of glucose and is most problematic in decomposed bodies. Vitreous humor is isolated from the gut, has fewer bacteria, and is less susceptible to PME. If vitreous alcohol ≥ blood alcohol concentration, it supports true antemortem consumption (alcohol distributes to vitreous over time). If only blood has alcohol with minimal or no vitreous alcohol, PME is more likely. Additional markers include vitreous β-hydroxybutyrate, n-propanol (a PME fermentation byproduct), and the absence of CDT.
Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.