Duan Yijie, Zhang Lin, Li Shangxun, Yang Yi, Xing Jingjun, Li Wenhe, Wang Xinmei, Zhou Yiwu
Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China.
Department of Public Security of Hubei Province, No.181 Xiongchu Avenue, Wuhan, 430070, PR China.
Forensic Sci Int. 2014 May;238:e6-e10. doi: 10.1016/j.forsciint.2014.02.021. Epub 2014 Mar 5.
Vaginal tightening is a kind of esthetic surgery aimed at enhancing sexual satisfaction during intercourse. Although the injective vaginal tightening procedure is informal, there are already some reports of its application. But pulmonary embolism is a really rare therapeutic complication of this procedure. We report a case of death due to the non-thrombotic pulmonary embolism as a consequence of illegal cosmetic vaginal-tightening procedure using polyacrylamide hydrogel. A 34-year-old woman was hospitalized with paroxysmal abdominal cramps and diarrhea as initial symptoms, while she concealed the genital cosmetic surgery history. Respiratory distress presented only 1.5h before she died. The result of autopsy revealed the cause of death as pulmonary embolism due to the hydrogel which was injected into her vaginal wall. The emboli were confirmed as polyacrylamide hydrogel by Alcian-blue stain and the Fourier transform infrared scanning. It is suggested that pulmonary embolism should not be discarded in the expertise of deaths following cosmetic implant surgeries. It broadens our understanding about death associated with esthetic genital procedures and informs clinicians and medical examiners of the potential death of this type. And detailed investigations of previous medical and surgical history will always play a critical role in the certification of cause of death.
阴道紧缩术是一种旨在提高性交过程中性满意度的美容手术。尽管注射式阴道紧缩术并不正规，但已有一些关于其应用的报道。不过，肺栓塞是该手术极为罕见的治疗并发症。我们报告一例因使用聚丙烯酰胺水凝胶进行非法美容阴道紧缩术导致非血栓性肺栓塞死亡的病例。一名34岁女性因阵发性腹部绞痛和腹泻作为初始症状入院，同时她隐瞒了生殖器美容手术史。呼吸窘迫仅在她死亡前1.5小时出现。尸检结果显示死亡原因是注入阴道壁的水凝胶导致的肺栓塞。通过阿尔辛蓝染色和傅里叶变换红外扫描确认栓子为聚丙烯酰胺水凝胶。建议在美容植入手术相关死亡的专业鉴定中不应忽视肺栓塞。这拓宽了我们对与美容性生殖器手术相关死亡的认识，并告知临床医生和法医这种类型的潜在死亡情况。对既往医疗和手术史的详细调查在死因认证中始终起着关键作用。
