forensic science, forensic pathology, bezoar, intestinal obstruction, kaolin, uterus myomatosus

A young adult black female, known to be a prostitute and suspected of smuggling narcotics, was found dead in her apartment in astate of early decomposition. Oval-shaped gray-white masses of exogenous origin protruded from the anus. The autopsy showed dilatation of thefolds of the large intestine, which were almost completely filled with these oval-shaped gray-white masses of foreign material. The uterus wasenlarged with multiple large leiomyomas. Toxicological tests of blood and the foreign material revealed no toxicologically relevant substances.Kaolin was detected in a sample of the foreign material from the large intestine. The immediate cause of death was intestinal obstruction due to theformation of a kaolin bezoar with simultaneous compression of the large intestine by the enlarged myomatous uterus. Subsequent revelation of ahabit the deceased had brought from her native country led to the conclusion that this exotic custom was responsible for her death.