Fatal air embolism during female autoerotic practice

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Abstract
Air embolism has been described in pregnant women and is a classic cause of death during attempted abortion by syringing. Death was caused by the introduction of an amount of air sufficient to cause a substantial air lock in the heart, pulmonary trunk or arteries. If the surface of the placenta has been stripped by the syringe, venous spaces are opened and air can pass into the circulation. Orogenital sex with vaginal insufflation can also cause air embolism during pregnancy. We report a case of air embolism in a 40-year-old non-pregnant woman subsequent to vaginal insertion of a foreign body (carrot) for an autoerotic purpose. The mechanism is roughly similar to syringing, the foreign body acting like a piston to displace a sufficient amount of air. In the present case, the endometrium stripping was probably due to the presence of an intrauterine device. As such risks may often be encountered and as, to our knowledge, no similar case has previously been reported, we may speculate if such air embolisms are underdiagnosed or dissimulated by the partners when questioned by the medical rescue teams. Verschiedene Formen der Luftembolie bei schwangeren Frauen sind bekannt, z. B. im Rahmen von Abtreibungsmaßnahmen und auch bei orogenitalen sexuellen Praktiken. Dargestellt wird der Fall einer tödlichen Luftembolie bei einer 40 Jahre alt gewordenen nicht-schwangeren Frau im Rahmen autoerotischer Handlungen mit einer Karotte. Das Eindringen von Luft über das Endometrium wurde wahrscheinlich durch Mikroläsionen aufgrund eines intrauterinpessars begünstigt.

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