Compressed air as a silent lethal weapon: A forensic autopsy case report of fatal colonic barotrauma and tension pneumoperitoneum.
Source: PubMed, NCBI / U.S. National Library of Medicine
Compressed air-induced colonic barotrauma is a rare but potentially fatal injury type with distinctive forensic significance. Non-iatrogenic pneumatic injuries of the gastrointestinal tract are infrequently documented, yet are associated with high morbidity and mortality, frequently arising in occupational settings because of workplace misconduct or the misuse of pneumatic equipment. We report a fatal case of transanal high-pressure compressed air insufflation in a 15-year-old adolescent. Witness testimony and the accused's confession established that a compressed air hose was inserted transanally on two occasions while the victim was fully clothed. The second instance of insufflation resulted in immediate collapse at the scene with subsequent death. Medicolegal autopsy was conducted at the Egyptian Forensic Medicine Authority. External examination revealed a grossly distended abdomen as well as a grossly distended scrotum, and two vital perianal lacerations with contused and abraded margins, accompanied by perianal bruising. Internal examination demonstrated tension pneumoperitoneum, multiple colonic and mesenteric lacerations, and intraperitoneal hemorrhage. Toxicological analysis and anal swabs for evidence of sexual assault were negative. The cause of death was attributed to hemorrhagic shock secondary to extensive multiple colonic and mesenteric lacerations. Compressed air-induced colonic barotrauma, though rare, represents a forensically significant injury pattern. The
Abstract
Compressed air-induced colonic barotrauma is a rare but potentially fatal injury type with distinctive forensic significance. Non-iatrogenic pneumatic injuries of the gastrointestinal tract are infrequently documented, yet are associated with high morbidity and mortality, frequently arising in occupational settings because of workplace misconduct or the misuse of pneumatic equipment. We report a fatal case of transanal high-pressure compressed air insufflation in a 15-year-old adolescent. Witness testimony and the accused's confession established that a compressed air hose was inserted transanally on two occasions while the victim was fully clothed. The second instance of insufflation resulted in immediate collapse at the scene with subsequent death. Medicolegal autopsy was conducted at the Egyptian Forensic Medicine Authority. External examination revealed a grossly distended abdomen as well as a grossly distended scrotum, and two vital perianal lacerations with contused and abraded margins, accompanied by perianal bruising. Internal examination demonstrated tension pneumoperitoneum, multiple colonic and mesenteric lacerations, and intraperitoneal hemorrhage. Toxicological analysis and anal swabs for evidence of sexual assault were negative. The cause of death was attributed to hemorrhagic shock secondary to extensive multiple colonic and mesenteric lacerations. Compressed air-induced colonic barotrauma, though rare, represents a forensically significant injury pattern. The current case illustrates the severe, potentially fatal effects of using pneumatic devices improperly and emphasizes the importance of considering scene evidence, witness statements, external examinations, and comprehensive internal autopsy findings to accurately reconstruct the mechanism, manner, and cause of death.