Deaths due to hunger strike: post-mortem findings

Decubitus ulcers and ligature marks as evidence in a homicide case

“…Data gained from autopsy (cutaneous retractions, subcutaneous and internal fat reduction presence of dry stool) as well as histological alterations observed in the liver (centrilobular necrosis attributable to protein deficiency, accompanied by a significant increase in lipofuscin) and heart suggested long-term food deprivation [7][8][9][10]. The woman had no history and/or physical evidence of any medical cause of weight loss (terminal illness, anorexia nervosa etc).…”

Medical Management of Hunger Strikers

“…9 In complete fasting without water, sucrose, or vitamin supplementation, the mean survival time is 61 days. 10 Of note, thiamine deficiency instead of acaloric malnutrition may be the cause of death in patients who continue to receive sucrose without thiamine. There is some evidence that thiamine supplementation may prolong time to death.…”

“…There is some evidence that thiamine supplementation may prolong time to death. 10 In addition, recent evidence suggests that gluconeogenesis in the kidneys (as opposed to the liver) may be an important factor in surviving prolonged starvation and is determined at least partially by the p ratio and the degree of adiposity. 9 Thus, the response to starvation is not stereotypical and is hard to predict.…”

Child Deaths

“…Starvation can be due to insufficient delivery or non-delivery of food, delivery of improper food, severe loss of appetite or social hunger (Cologlu & Cakalir 1999) Starvation is the condition where there is severe loss of vitamins, minerals, nutrients and energy (Altun & Altun 2010). During the early days of starvation, the glycogen stored in the liver and muscles are used as energy source but glycogen may be understored in children (Altun et al, 2004). As carbohydrates deplete, proteins and fats become the main source of energy.…”

“…Gastrointestinal organs shrink. Digestive tract is empty; dilatation may be observed in the gall bladder; hepatic adiposity may be observed (Cologlu & Cakalir 1999, Altun et al, 2004. Diabetes mellitus findings are absent in mortality due to starvation but ketoacidosis may be present in blood (Milroy & Parai 2011).…”