Rectal Explosion: a Strange Case of Autoerotic Death

hermantheshocker · #1 ● 08-06-2020, 05:43 PM

A 35-year-old male crawled from the ground floor to the first floor of a factory hall where he worked and franticly shouted at his coworkers: “I am so sorry; it was all my fault.” He complained of profuse rectal bleeding and severe abdominal pain. He explained that the sustained injury had been caused by a silly experiment with the central distribution pressurized air facility at the factory. He repeatedly stressed that the incident was his own fault. During transportation to the hospital by a helicopter, the man became unresponsive and developed signs of hemorrhagic shock. Despite resuscitation efforts, he died before admission to the hospital. Because of the strange characteristics of the case and unusual circumstances at the location of the incident, the police ordered a medicolegal autopsy.

Autopsy findings
External examination revealed a Caucasian male of medium build (height, 175 cm; weight, 82 kg). The most prominent external findings were subcutaneous edema and emphysema of the cervicofacial soft tissues. The deceased anogenital area was emphysematous and covered with dense dried blood, and there were radial tears of the skin around the anus.

Police investigations confirmed that the man had used a prototype rubber inflatable pipe stopper for autoerotic anal stimulation. The possible sequence of events was as follows: the man initially mounted a rubber pipe stopper (diameter 50–70 mm) after coupling it to the muzzle end of an air blow gun connected to the air-distribution system via a long high-pressure hose. Afterwards, he coated the pipe stopper with a plastic bag and inserted the whole complex into his rectal cavity. Finally, he pressed the trigger of the air blow gun, resulting in an unexpected abrupt inflation and explosive bursting of the pipe stopper within his rectum.

Autopsy picture a) Air bubbles within the cortical cerebral veins (blue arrow).
Internal examination of the brain revealed air bubbles within cortical veins and severe brain edema (cortical vessels were examined by osteoclastic trepanation of the right temporal bone to eliminate artifacts). Tests for pneumothorax and air embolism were both positive.

Autopsy picture b) Positive test for pneumothorax, that is, air bubbles escaping from the right pleural cavity after the intercostal perforation with a needle.
Inspection of the thoracic cavity identified hemorrhagic infiltration of the intercostal spaces between the 1st and 2nd ribs and between the 5th and 10th ribs on the right side (extending from the spine to the posterior axillary line) and confluent hemorrhages alongside the right posterior costal attachment of the diaphragm. Further preparation of the thoracic organs showed patchy hemorrhages beneath the endocardium of the left cardiac chamber, patent foramen ovale, petechial hemorrhages under both pleurae, and hemorrhages within both pulmonary hili.

Autopsy picture c) Hemorrhagic avulsion of the right part of the abdominal wall.
Examination of the abdominal cavity showed hemorrhagic avulsion of the right part of the abdominal wall, fluid blood within the abdominal cavity, hemorrhagic infiltration of mesenteric roots, both omenta, and the right renal hilus.

Autopsy picture d) The open abdominal cavity with fluid blood and torn fragments of the rubber pipe stopper (blue circles).
It also revealed three foreign objects lodged between the loops of the small intestine, identified as irregular particles of the burst black rubber stopper coated with parts of a torn plastic bag (fragments of the burst rubber pipe stopper. Inspection of the pelvic organs in situ revealed an almost circular lacerated abruption of the rectum, severe hemorrhagic infiltration of soft tissues around the rectum, and intimal tears within the left common iliac artery. Viscera were generally pale, and the heart was shrunken and empty.

The autopsy failed to reveal any changes related to natural diseases. Blood and urine alcohol levels and other routine toxicological investigations were all negative. The cause of death was attributed to traumatic hemorrhagic shock resulting from explosive rectal injury. Upon the conclusion of all investigations, the cause of death was recorded as an accidental autoerotic fatality.

The medical history of the deceased was unremarkable, and he had received no prior psychiatric treatment. However, his sexual history confirmed an interest in anorectal sexual practices, and he was a registered member of an amateur sex website dealing with both typical and uncommon sexual practices. He regularly contributed to the website with self-portraits depicting his autoerotic activities, including anorectal autoeroticism involving the insertion of oversized foreign bodies into the rectum.