Aspetti anatomopatologici delle morti per intossicazione acuta da sostanze stupefacenti nel settorato medico-legale barese

Records of the Institute ofLegal Medicine ofthe University of Bari (Italy) were reviewed for cocaine-morphine related deaths occurring between 1989 and1991. Thirteen cases of cocaine and 100 cases of morphine related deaths were studied. Cardiovascular and hepatic findings were analyzed, respectively, for cocaine and morphine acute lethal intoxication. For cocaine in one case of cocaine acute intoxication, the cause of death was induced by the rupture of a Berry aneurism: in five cases a right ventricular dysplasia was considered a contributory factor. Left ventricular hypertrophy and histological evidence of myocardial patchy fibrosis were constantly observed. The absence of myocardial nodular fibrosis was related with the phenomenon o f cocaine use by the voung in Italy. In morphine related deaths, non specific, chronic, persistent lobular and active hepatitis were constatntly observed at virtually the same rate. The hepatic rindings observed were more serious than those described in literature for similar case reports, and were presumed to be related to the influence of the endemic HCV infection present in our region.