Forensic medical criteria: evaluation of fatty liver degeneration in acute and chronic intoxication with alcohol substitutes

The article presents an analysis of pathomorphological changes in internal organs and the brain in cases of chronic alcohol intoxication and alcohol surrogate poisoning. A statistically significant decrease in glycogen content in the liver and glucose in the blood was found in alcohol intoxication cases compared to controls. Hepatic changes were observed in most cases, predominantly as fatty degeneration, as well as alcoholic hepatitis and cirrhosis. The frequency of hepatitis and cirrhosis was higher in alcohol surrogate poisonings than in chronic alcohol intoxication. Alcoholic cirrhosis was often accompanied by gastroesophageal bleeding (Mallory–Weiss syndrome), one of the causes of which was cerebral edema with herniation. Morphologically, such cases – especially in surrogate alcohol intoxication – were characterized by focal necroses and pontine myelinolysis. Thus, chronic alcohol intoxication leads to the depletion of the body's energy resources (glycogen and glucose), and continued intoxication results in the consumption of protein reserves (amino acids).