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Gross Examination and Toxicological Analysis of Gastrointestinal Tract in Fatal Cases of Poisoning by Nuvan Insecticide: A Case Report

Jyotsnessh Chauhan*

“Nuvan” is a trading name of Dichlorvos (DDVP) organophosphate insecticide. The lethal dose of DDVP is very low for oral and dermal exposure, hence classified as a highly hazardous pesticide by WHO. Nuvan contains 76% DDVP and is accessible in India after the recent ban. Nuvan Insecticide is highly misused and orally ingested in suicide attempts. Insecticide poisoning is one of the leading causes of poisoning deaths in Indian rural areas. In this case series, we have diagnosed the four poisoning deaths by Nuvan-dichlorvos insecticide through post-mortem examination and toxicological analysis. The stomach and contents were grossly examined, a fluorescent turquoise blue liquid content was found throughout the stomach and small intestine. Liquid content had a notable odor of Volatile Organic Compounds (VOCs). The mucosal walls of the stomach were highly congested and hemorrhagic. These gross characteristics of stomach content are significant for screening Nuvan insecticide. Toxicological analyses were performed for the stomach and content by Thin Layer Chromatography (TLC) using spraying reagent and DDVP was detected. As of now, the ministry of agriculture and farmers welfare (India) has completely banned the use of DDVP, but there are still chances to encounter Nuvan as the fatal cases were reported after prohibition. Thus, the simple gross examination of gastrointestinal viscera (stomach and intestine) is supporting diagnostic evidence for orally administered insecticide. Nuvan can also be screened through gastric lavage. The toxicological analysis has to be performed for the chemical confirmation and will determine illegitimate pesticides that are still available in the market and threatening life.