Death due to ingestion of concentrated sulfuric acid.
Top Left: Acid burns, resulting from ingestion of the acid. Note the burns to the mouth and the spill pattern on the face and chest. These are significantly different from thermal-type burn patterns and injuries.
Top Right: Note the spill pattern on the anterior chest and abdomen of the decedent from the previous image.
Center: Burns from the acid, on the tongue, hypopharynx, and airway. Burns extended down esophageal tract, though esophagus was considerably less burned than remainder of upper GI tract.
Bottom Left: Acid injury extending through the viscera and onto the pleural surface exposing the ribs of the decedent.
Bottom Right: Coagulation necrosis of the solid organs from the acid ingestion of the decedent.
Sulfuric acid is often not a quick death, and can cause delayed tissue perforation and necrosis up to a week after exposure. Exposure of tissues to strong acids can cause coagulation burns, and destruction of epithelial tissue and submucosa. The acid is not known to have systemic effects, and is only locally active, meaning that any neurological symptoms experienced are a direct result of the pain caused by tissue destruction.
When a patient survives the initial ingestion of sulfuric acid, swelling of the pharynx and continuing destruction of the GI tract are primary concerns. Many cases require surgery to remove or repair perforated areas in intestine and stomach. Metabolic acidosis is also a key concern in treating patients of acid ingestion, as it can lead to ventricular arrhythmias, as well as organ damage.