A Retrospective Autopsy Study on Postmortem Findings and Toxicological Analysis in Fatal Poisoning Cases at a Tertiary Care Centre

Background: Poisoning remains a significant cause of unnatural death globally, posing considerable diagnostic challenges in forensic pathology. Objective: This study aimed to characterize the demographic profile, postmortem macroscopic and microscopic findings, and toxicological analyses in fatal poisoning cases examined at a tertiary care center. Methods: This retrospective cross-sectional study reviewed 150 autopsy records of individuals who died due to acute poisoning between January 2025 and June 2025 at the Department of Forensic Medicine and Toxicology at Rajshahi Medical College Hospital. Collected date included demographics, circumstances of death, external and internal autopsy findings, histopathological observations, and toxicological reports. Statistical analysis was performed using SPSS version 26.0. Results: Of the 150 cases, males constituted 68% (n=102) and females 32% (n=48), with the most affected age group being 21-30 years (30%, n=45). Suicidal intent was the predominant manner of death (58%, n=87). Organophosphate compounds (58.7%, n=88) were the most common poison, followed by alcohol poisoning (25.3%, n=38) and phosphides (12.7%, n=19). Prominent external findings included froth at mouth/nostrils and chemical burns around the mouth. Internal examinations frequently revealed generalized visceral congestion (100%), pulmonary edema (80%), and specific gastrointestinal changes such as mucosal congestion or corrosion or ulceration (83.3%). Histopathology often showed acute inflammatory changes and organ-specific necrosis. Toxicological analysis confirmed the suspected poison in 98% of cases. Conclusion: Fatal poisoning cases predominantly involve young to middle-aged males, with suicidal intent being the leading manner of death. While non-specific findings like visceral congestion and pulmonary edema are common, a combination of meticulous autopsy, relevant histopathology, and comprehensive toxicological analysis is crucial for accurate diagnosis and medicolegal certification.