L. Hagemeier

Two cases of suicide by asphyxiation due to helium and argon

Numerous death cases due to suffocation in a toxic or oxygen deficient gas atmosphere have been described in the literature, but unfortunately especially cases involving inert gases like helium are often presented without detailed toxicological findings. Observations on two suicides are reported, one by helium and the other by argon inhalation. During autopsies gas samples from the lungs were collected directly into headspace vials by a procedure ensuring minimal loss and dilution. Qualitative gas analyses were performed using headspace gas chromatography-mass spectrometry (HS-GC/MS). For carrier gas the commonly used helium was replaced by hydrogen. Qualitative positive results were obtained in the argon case, but the case involving helium revealed negative findings. The use of HS-GC/MS enables in principle to detect inert gases like argon or helium. However, a number of factors may later influence the results as, e.g. a longer period of time between death and sampling or pre-analytical artefacts during sampling of such highly volatile substances. In absence of analytical data supporting helium exposure, the causes of death in the actual cases were found to be asphyxia and in both cases the manner was suicide.

Postmortem diagnostics of assumed food anaphylaxis in an unexpected death

Diagnosis of lethal anaphylaxis is known to be difficult to establish in forensic autopsy. Cases of anaphylactic shock have to be dealt with in forensic medicine comparatively frequently as death due to anaphylaxis is likely to occur rapidly and without warning in seemingly healthy subjects. Autopsy findings might hint at allergic reaction, but classic manifestations can also be completely absent. A case of suspected food anaphylaxis in a middle-aged woman is presented. The deceased had been known to suffer from multiple allergies. Death came about after an evening meal with friends. Dyspnoea was reported to have been followed by collapse, unconsciousness and death within minutes. The course of further analysis undertaken (toxicology, biochemistry, immunohistochemistry) is examplarily described. By means of the results presented we discuss problems and possibilities of postmortem diagnostics of food induced anaphylaxis.

Suicide by head explosion: Unusual blast wave injuries to the cardiovascular system

A 57-year-old employee in a military scientific institute was found acephalous in a supine position in an anteroom to the bunker. On the walls was abundant spattering of blood and tissue, concentrated above shoulder height. A mobile ignition device stood on the control desk. The complete destruction of the head down to the cervical spine suggested that the explosive charge (RDX) detonated in his mouth. The hands were virtually uninjured. The pressure effect in vessels caused numerous tears to the wall of the carotid arteries and the left vertebral artery, a tear-off of the left carotid artery of the aortic arch, and a 2.5-cm long crack of the thoracic aorta with 540-ml blood in the pericardial sac and a shredded window-like disruption of the left aortic valve cusp. The autopsy also showed an infraction of the sternum from the inside, and a contusion of the superior lobes of both lungs. The trace pattern on the right arm suggested suicide. A bone fragment of the mandible penetrated the right biceps muscle as a secondary projectile.

Unattended fatal haemorrhage due to spontaneous peripheral varicose vein rupture—Two case reports

Venous haemorrhage is a rare complication of varicose veins of the legs. Varicosis is found in 15-50% of the population. Haemorrhage from ruptured varicose veins of the legs can occur spontaneously or after a minor trauma. More frequent complications of varicosis include peripheral oedema of the ankles, skin pigmentation and skin ulcers. In case of venous haemorrhage simple possibilities of first aid can be applied, therefore fatal haemorrhage is a rarity. Two cases of fatal varicose vein rupture are presented. A 58-year-old man and a 76-year-old woman, both living alone, were found dead in the bathrooms of their apartments. Significant traces of blood were found in all rooms. Both corpses showed typical signs of death from exsanguination. No traumatic lesion was found. Cause of the haemorrhage was a small lesion of the skin of the lower legs of the victims with continuation to an underlying superficial varicose vein. Misinterpretation of life-threatening varicose haemorrhage, unconsciousnous, alcohol or drug influence, old age and dementia can promote the death. In case of fatal haemorrhage the death scene can simulate crime due to massive traces of blood and may focus primarily on a non-natural death. However, police investigations and autopsy will disclose the rare cause of spontaneous natural death.

Extended suicide using an atypical stud gun

Suicides with stud guns are uncommon, but are well documented in the literature. On rare occasions, stud guns are also used as a homicide weapon. This case report describes an extended suicide in which a husband killed his wife and their two dogs, which lived on the property. The husband then committed suicide with a shot from the stud gun into his skull. He was a 70-year-old pensioner, a retired butcher, who was found by his son. He was lying in a supine position on a carpet in the living room, with the stud gun stuck in his skull. During autopsy, high concentrations of an antihistamine were found in the blood of each corpse; this drug is used as a soporific. In contrast to the literature, which mainly describes powder deposits due to the use of conventional stud guns, in this case a stud gun was used in which the expanding gases and powder escaped together with the central bolt at the front of the device; powder drains were not involved. Detailed findings of the autopsy are given with reference to this type of stud gun.