Sudden death after isobutane sniffing: a report of two forensic cases

Abstract

The intentional inhalation of a volatile substance ("sniffing") causing euphoria and hallucinations is an under-recognised form of substance abuse in children and adolescents with a high morbidity and mortality. Sudden death can be caused by cardiac arrhythmia, asphyxia or trauma. Two fatal cases of isobutane sniffing of cigarette lighter refill containing isobutane are reported. Toxicological investigations revealed the presence of isobutane in the heart blood and brain tissue of both cases (case 1: heart blood 0.1 microg/g, brain tissue 2.3 microg/g; case 2: heart blood 4.6 microg/g, brain tissue 17.4 microg/g) and the presence of its metabolite 2-methyl-2-propanol in the heart blood of both cases (0.5 and 1.8 microg/g, respectively). The histological investigations of the inner organs showed similar results in both victims. Autopsy findings, results of the histological and immunohistochemical investigations, toxicological findings and analytical procedures are discussed.

A Case Report: Convulsion and Reduced Level of Consciousness in Two Children Following Liquefied Petroleum Gas Inhalation

“…In the case of our patients, the gas cylinders containing LPG had been off and the children had been poisoned when playing with them due to opening their valves and direct inhalation of LPG [6]. This study is important in this respect that clearly shows that poisoning by pure LPG inhalation can cause neurological damage manifesting as reduced level of consciousness and convulsion.…”

Butane Gas Inhalation Resulting in Death: Two Case Reports

“…At the beginning of volatile substance inhalation, the release of catecholamines in explosive form may trigger ventricular fibrillation and cause 'sudden inhalation death' [16]. According to the medical records, in one of the current cases, cardiac arrhythmia and ventricular fibrillation had occurred before death.…”

“…More than half of the sudden deaths occurring as a result of volatile substance use have been reported to be associated with direct toxic effects, primarily cardiac [16]. In this context, a continuous increase is seen in the number of sudden deaths occurring because of causes such as cardiac arryhtmia, respiratory depression or hypoxia [19].…”

“…In this context, a continuous increase is seen in the number of sudden deaths occurring because of causes such as cardiac arryhtmia, respiratory depression or hypoxia [19]. Therefore, despite autopsies of cases, the process of researching the origin and cause of death is very complicated [16]. In a study in the USA of 110 cases associated with volatile substance use, an epidemic of sudden death was determined, with no anatomic defect in the autopsy results to explain the sudden deaths.…”

Ergenler Arasında Çakmak Gazı Soluma Sonucu Ani Ölüm Olgu Sunumu

“…kardiyak) etkilere bağlı olduğu belirtilmiştir (10,11). Bu bağlamda meydana gelen ölümlerin sayısında sürekli bir artış gözlenmektedir.…”