No abstract

Among the various modes of death due to asphyxiation, drowning is unique. Unlike other types of suffocation associated with occluding airway obstructions (i.e. choking and smothering); with drowning, there is typically filling and involvement of the majority of the tracheobronchial tree and aerodigstive tract. Although the usual drowning medium is water, it can also occur in other media. Moreover, although drowning sometimes occurs in the setting of a motor vehicle accident, an element of vehicular submersion or immersion is usually operative in such instances. The case presented here is that of a motor vehicle crash which resulted in drowning where no immersion of the vehicle occurred. Moreover, the drowning medium was paraffin wax, rather than water. Other cases in the literature of drowning in atypical media and also those which are reported in the concomitant presence of a motor vehicle accident are presented.

Homicides exclusively due to genital trauma have not been widely reported, and anorectal trauma in sexual assaults is uncommon. We describe a case of a 45-year-old white woman who sustained devastating homicidal colorectal trauma that served as a primary cause of death in the setting of rape. Our patient sustained a 15-cm laceration of the anterior rectal wall and ultimately died of peritonitis and sepsis. Death from rectal perforation and sepsis in the setting of sexual assault is rare and has only been documented in 3 other cases, 2 pediatric patients and 1 elderly debilitated patient. Other representative and unique methods of perforation are reviewed along with a brief discussion of the development of peritonitis after perforating colorectal trauma.