Poland. A grandmother found the corpse of her grandson in an apartment in a block of flats in one of the city settlements. The corpse was in the room and laid next to the bed, the anterior surface of the body facing the ground. On the man’s head, there was a tightly closed plastic bag attached to his neck with adhesive tape. A plastic tube protruded from under the bag, and the other end was connected to a cylinder filled with helium, which was placed on the decedent’s bed. The cylinder did not have a pressure-reducing valve.
Fig.1 A plastic bag on the head and a cylinder with helium in a cardboard box without pressure reducing valve.
After turning the corpse to a supine position, a significant amount of liquid blood flowed out of the mouth and the external nares. A forensic pathologist arrived at the scene and found the presence of subcutaneous emphysema on the face, neck, shoulder area, and anterior thoracic surface, as well as a large amount of blood in the oral cavity and nasal openings, which also covered the entire head.
Fig.2 The corpse after turning to the supine position and removing a plastic bag from the head.
The forensic medical autopsy findings included bilateral pneumothorax, blood in the pleural cavities, and massive hyperemia of the lungs (the blood flooded the autopsy table after routine incisions) and putrefaction. The samples of organs collected during the autopsy were fixed in 4% buffered formalin solution and slides were stained classically with hematoxylin and eosin and additionally with silver salts for silver-absorbing fibers. Both stainings revealed massive destruction of inter-alveolar septa.
Fig.3 Scene of discovery of the corpse.
The established cause of death of the man was a pressure injury (barotrauma) associated with the use of a cylinder with helium without a reducer, resulting in damage to the pulmonary interstitium with subsequent bleeding and pneumothorax and suffocation associated with the absence of oxygen.
Fig.4 Lungs, H&E staining – the ruptured alveoli (top), silver staining – the ruptured alveoli.
Helium is a chemically inert gas present in atmospheric air that is used in various branches of industry and in medicine. In the case of its improper use, various complications may occur, affecting mainly the respiratory tract and, in extreme cases, even resulting in death. Helium has also been used for committing suicide. Helium suicide is a method that does not leave characteristic macro-and microscopic post-mortem changes.
A large amount of information on how to commit suicide with the use of helium can be found on the internet, which contributes to the popularization of this method in the world. In the case of incompetent use of the equipment theoretically dedicated to such suicide, death may occur not because of the suffocation, which is the most common mechanism in such cases, but because of a pressure injury of the respiratory tract, resulting in rapid damage to the alveoli in the rupture mechanism, causing massive bleeding.
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