Air weapons use compressed gas to fire projectiles without igniting gunpowder. Although commonly perceived as recreational devices, modern air rifles can reach muzzle velocities exceeding 1000 feet per second and are capable of inflicting fatal injuries. This report describes 2 unusual fatalities from air weapon chest wounds: a 15-year-old male who sustained a self-inflicted injury while handling an air rifle, and a 61-year-old male shot by another individual. Both victims died shortly after sustaining the wound despite medical intervention. Autopsies revealed penetrating chest injuries with retained wasp-waisted pellets within the left lung, and the manner of death was certified as suicide and homicide, respectively. A literature review identified only a few comparable fatalities, including 2 suicides and 3 homicides involving chest injuries. Despite their small caliber and widespread availability, air weapons can produce sufficient kinetic energy to penetrate skin, bone, and vital organs. These cases emphasize the lethal potential of air rifles and the diagnostic challenges they can present during forensic investigation. While commonly regarded as low-risk devices, these weapons demonstrate considerable lethality and should be subject to stronger regulatory oversight.
Air weapons use compressed gas to fire projectiles without igniting gunpowder. Although commonly perceived as recreational devices, modern air rifles can reach muzzle velocities exceeding 1000 feet per second and are capable of inflicting fatal injuries. This report describes 2 unusual fatalities from air weapon chest wounds: a 15-year-old male who sustained a self-inflicted injury while handling an air rifle, and a 61-year-old male shot by another individual. Both victims died shortly after sustaining the wound despite medical intervention. Autopsies revealed penetrating chest injuries with retained wasp-waisted pellets within the left lung, and the manner of death was certified as suicide and homicide, respectively. A literature review identified only a few comparable fatalities, including 2 suicides and 3 homicides involving chest injuries. Despite their small caliber and widespread availability, air weapons can produce sufficient kinetic energy to penetrate skin, bone, and vital organs. These cases emphasize the lethal potential of air rifles and the diagnostic challenges they can present during forensic investigation. While commonly regarded as low-risk devices, these weapons demonstrate considerable lethality and should be subject to stronger regulatory oversight.
Blue Rubber Bleb Nevus Syndrome (BRBNS) is a rare congenital disorder characterized by multiple venous malformations, most frequently affecting the skin and gastrointestinal tract, but occasionally involving the central nervous system and other visceral organs. Fatal outcomes are exceedingly rare and usually result from acute hemorrhage or airway compromise. This report describes a fatal case of BRBNS in a 31-year-old woman who developed uncontrollable bleeding from vascular malformations following an emergent tracheostomy performed for anaphylaxis secondary to lidocaine administration during dental treatment. Despite aggressive resuscitative measures, the patient succumbed to hemorrhagic shock. External examination revealed bluish subcutaneous lesions in the perioral region, periorbital ecchymosis, and multiple bluish, compressible subcutaneous vascular "blebs" on the right upper extremity, extending to the right hemithorax. Internally, multiple submucosal, hemorrhagic-appearing lesions were identified on the base of the tongue, hypopharynx, larynx, and aryepiglottic folds, with additional vascular malformations in the posterior mediastinum and right temporalis muscle. Histologic examination confirmed cavernous hemangiomas at the tracheostomy site. A review of the English-language literature revealed only a small number of fatal cases associated with BRBNS. This case highlights the potential for fatal airway hemorrhage in BRBNS, particularly during emergent procedures involving the upper airway. Awareness of possible laryngeal and tracheal involvement is crucial to avoid iatrogenic complications. Comprehensive autopsy remains essential to determine the cause of death, document lesion distribution, and distinguish disease-related hemorrhage from procedural injury.
Sudden cardiac death due to an isolated right ventricular thromboembolism is an uncommon cause of death. In the reported case, a healthy, asymptomatic young male with no past medical history outside of obesity and his age was found unresponsive by a family member who suspected him to be sleeping. Examination of the heart at autopsy revealed a large serpiginous, organized and obstructive blood clot compromising most of the right ventricle with no other cardiac abnormalities and without any evidence of a pulmonary embolism. The patient was found to not have any history of substance abuse, genetic predispositions, kidney disease, or COVID-19 infection which has all been linked to ventricular thrombi.
