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A Case Series of Butane Intoxication Fatalities in the Southeastern Anatolia Region of Türkiye

Yıl 2023, Cilt: 5 Sayı: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic, 138 - 43, 19.10.2023
https://doi.org/10.37990/medr.1343983

Öz

Aim: Volatile solvent abuse (VSA), is the third most common form of substance abuse after alcohol and cigarettes. The aim of this study was to determine the incidence of fatalities due to butane gas.
Material and Methods: From 8,075 autopsies conducted in our center in Şanlıurfa, Türkiye in a 10-year period, 10 deaths were determined to be due to butane gas intoxication.
Results: All the fatalities were males (mean age: 17.6 years). Friends reported chronic use of lighter gas by the fatalities prior to the incident. In contrast, close relatives stated that it was the first instance of VSA. The preferred inhalation methods were bagging (i.e., inhaling gas from a plastic bag, n=4) and direct inhalation (i.e., spraying the gas directly in the mouth, n=6). The scene of incident findings revealed more than one lighter gas cartridge at the scene in nine cases and many lighters at the scene in one case. The autopsy examinations revealed minimal grazing on the body in three cases and no traumatic findings in seven cases. Butane was detected in blood samples in all 10 cases and in lung tissue samples in eight cases. In all 10 cases, there were areas of intra-alveolar swelling, edema, and bleeding in the lungs.
Conclusion: The actual incidence of VSA-related deaths is likely much higher than the number of reported cases, as our center is located near the Syrian border and has one of the highest populations of children and young people in Türkiye.

Kaynakça

  • Sugie H, Sasaki C, Hashimoto C, et al. Three cases of sudden death due to butane or propane gas inhalation: analysis of tissues for gas components. Forensic Sci Int. 2004;143:211-4.
  • Petekkaya S, Ayaz N, Dogan M, et al. A case of sudden death due to lighter refill gas inhalation. J Turgut Ozal Med Cent. 2016;23:107-10.
  • Bugra A, Das T. Postmortem diagnosis of myocardial infarction due to butane gas intoxication in a child: a case report. The American Journal of Forensic Medicine and Pathology. 2019;40:81-3.
  • Marsolek MR, White NC, Litovitz TL. Inhalant abuse: monitoring trends by using poison control data, 1993-2008. Pediatrics. 2010;125:906-13.
  • Anderson CE, Loomis GA. Recognition and prevention of inhalant abuse. Am Fam Physician. 2003;68:869-74.
  • Rossi R, Suadoni F, Pieroni L, et al. Two cases of acute propane/butane poisoning in prison. J Forensic Sci. 2012;57:832-4.
  • Durão C, Pedrosa F, Dinis-Oliveira RJ. Suicide by inhalation of butane gas through a homemade adaptation of a continuous positive airway pressure (CPAP) face mask. FForensic Sci Med Pathol. 2020;16:732-4.
  • Uchida K, Unuma K, Uemura K. A fatality in a child with severe fatty liver due to n-butane and isopentane poisoning resulting from long-term inhalation of an antiperspirant aerosol. Forensic Sci Med Pathol. 2015;11:631-2.
  • Wehner F, Benz D, Wehner H-D. Fatal inhalation of butane-propane gas. Arch Kriminol. 2002;209:164-8.
  • Jackowski C, Römhild W, Aebi B, et al. Autoerotic accident by inhalation of propane-butane gas mixture. Am J Forensic Med Pathol. 2005;26:355-9.
  • Williams DR, Cole SJ. Ventricular fibrillation following butane gas inhalation. Resuscitation. 1998;37:43-5.
  • Shintani-Ishida K, Tsuboi H, Ichioka H, Ikegaya H. Comparison of postmortem butane distribution between two fatal butane poisoning cases. Legal Medicine. 2018;35:69-72.
  • Sato T, Nishioka H, Tsuboi K, et al. Detection of butane gas inhalation at 16 days after hypoxic encephalopathy: a case report. Legal Medicine. 2017;29:34-7.
  • Sironi L, Amadasi A, Zoja R. Recreational inhalation of butane and propane in adolescents: two forensic cases of accidental death. Forensic Sci Int. 2016;266:e52-8.
  • National survey on drug use and health: trends in prevalence of various drugs for ages 12 or older, ages 12 to 17, ages 18 to 25, and ages 26 or older; 2015-2017 (in percent)* https://www.drugabuse.gov/national-survey-drug-use-health access date 29.12.2022.
  • Embleton L, Mwangi A, Vreeman R, et al. The epidemiology of substance use among street children in resource constrained settings: a systematic review and meta-analysis. Addiction. 2013;108:1722-33.
  • Ögel K, Tamar D, Evren C, Çakmak D. Uçucu madde kullanımının yaygınlığı: çok merkezli bir araştırmanın verilerinin değerlendirilmesi. Anadolu Psikiyatri Derg. 2000;1:220-4.
  • Marelich GP. Volatile substance abuse. Clin Rev Allergy Immunol. 1997;15:271-89.
  • Alunni V, Gaillard Y, Castier F, et al. Death from butane inhalation abuse in teenagers: two new case studies and review of the literature. J Forensic Sci. 2018;63:330-5.
  • El Balkhi S, Coutaz-Fluck C, Moreau F, et al. Is it worth carrying out determination of N-butane in postmortem samples? A case report and a comprehensive review of the literature. Int J Legal Med. 2016;130:1223-9.
  • Wille SMR, Lambert WEE. Volatile substance abuse - post-mortem diagnosis. Forensic Sci Int. 2004;142:135-56.
  • Gaillard Y, Masson-Seyer MF, Giroud M, et al. A case of drug-facilitated sexual assault leading to death by chloroform poisoning. Int J Legal Med. 2006;120:241-5.
  • Fuke C, Miyazaki T, Arao T, et al. A fatal case considered to be due to cardiac arrhythmia associated with butane inhalation. Leg Med (Tokyo). 2002;4:134-8.
  • Novosel I, Kovačić Z, Gusić S, et al. Immunohistochemical detection of early myocardial damage in two sudden deaths due to intentional butane inhalation. Two case reports with review of literature. J Forensic Leg Med. 2011;18:125-31.
  • De Naeyer AHRR, de Kort SWK, Portegies MCM, et al. Myocardial infarction in a 16-year old following inhalation of butane gas. Ned Tijdschr Geneeskd. 2011;155:A3443.
  • Sen A, Erdivanli B. Cardiac arrest following butane inhalation. Anesth Essays and Res. 2015;9:273-5.
  • Grigorov V, Grigorov M, Grigorov E, Nocheva H. Butane-induced acute global myocardial ischemia without coronary artery pathology. Oxf Med Case Reports. 2020;2020:omaa118.
Yıl 2023, Cilt: 5 Sayı: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic, 138 - 43, 19.10.2023
https://doi.org/10.37990/medr.1343983

Öz

Kaynakça

  • Sugie H, Sasaki C, Hashimoto C, et al. Three cases of sudden death due to butane or propane gas inhalation: analysis of tissues for gas components. Forensic Sci Int. 2004;143:211-4.
  • Petekkaya S, Ayaz N, Dogan M, et al. A case of sudden death due to lighter refill gas inhalation. J Turgut Ozal Med Cent. 2016;23:107-10.
  • Bugra A, Das T. Postmortem diagnosis of myocardial infarction due to butane gas intoxication in a child: a case report. The American Journal of Forensic Medicine and Pathology. 2019;40:81-3.
  • Marsolek MR, White NC, Litovitz TL. Inhalant abuse: monitoring trends by using poison control data, 1993-2008. Pediatrics. 2010;125:906-13.
  • Anderson CE, Loomis GA. Recognition and prevention of inhalant abuse. Am Fam Physician. 2003;68:869-74.
  • Rossi R, Suadoni F, Pieroni L, et al. Two cases of acute propane/butane poisoning in prison. J Forensic Sci. 2012;57:832-4.
  • Durão C, Pedrosa F, Dinis-Oliveira RJ. Suicide by inhalation of butane gas through a homemade adaptation of a continuous positive airway pressure (CPAP) face mask. FForensic Sci Med Pathol. 2020;16:732-4.
  • Uchida K, Unuma K, Uemura K. A fatality in a child with severe fatty liver due to n-butane and isopentane poisoning resulting from long-term inhalation of an antiperspirant aerosol. Forensic Sci Med Pathol. 2015;11:631-2.
  • Wehner F, Benz D, Wehner H-D. Fatal inhalation of butane-propane gas. Arch Kriminol. 2002;209:164-8.
  • Jackowski C, Römhild W, Aebi B, et al. Autoerotic accident by inhalation of propane-butane gas mixture. Am J Forensic Med Pathol. 2005;26:355-9.
  • Williams DR, Cole SJ. Ventricular fibrillation following butane gas inhalation. Resuscitation. 1998;37:43-5.
  • Shintani-Ishida K, Tsuboi H, Ichioka H, Ikegaya H. Comparison of postmortem butane distribution between two fatal butane poisoning cases. Legal Medicine. 2018;35:69-72.
  • Sato T, Nishioka H, Tsuboi K, et al. Detection of butane gas inhalation at 16 days after hypoxic encephalopathy: a case report. Legal Medicine. 2017;29:34-7.
  • Sironi L, Amadasi A, Zoja R. Recreational inhalation of butane and propane in adolescents: two forensic cases of accidental death. Forensic Sci Int. 2016;266:e52-8.
  • National survey on drug use and health: trends in prevalence of various drugs for ages 12 or older, ages 12 to 17, ages 18 to 25, and ages 26 or older; 2015-2017 (in percent)* https://www.drugabuse.gov/national-survey-drug-use-health access date 29.12.2022.
  • Embleton L, Mwangi A, Vreeman R, et al. The epidemiology of substance use among street children in resource constrained settings: a systematic review and meta-analysis. Addiction. 2013;108:1722-33.
  • Ögel K, Tamar D, Evren C, Çakmak D. Uçucu madde kullanımının yaygınlığı: çok merkezli bir araştırmanın verilerinin değerlendirilmesi. Anadolu Psikiyatri Derg. 2000;1:220-4.
  • Marelich GP. Volatile substance abuse. Clin Rev Allergy Immunol. 1997;15:271-89.
  • Alunni V, Gaillard Y, Castier F, et al. Death from butane inhalation abuse in teenagers: two new case studies and review of the literature. J Forensic Sci. 2018;63:330-5.
  • El Balkhi S, Coutaz-Fluck C, Moreau F, et al. Is it worth carrying out determination of N-butane in postmortem samples? A case report and a comprehensive review of the literature. Int J Legal Med. 2016;130:1223-9.
  • Wille SMR, Lambert WEE. Volatile substance abuse - post-mortem diagnosis. Forensic Sci Int. 2004;142:135-56.
  • Gaillard Y, Masson-Seyer MF, Giroud M, et al. A case of drug-facilitated sexual assault leading to death by chloroform poisoning. Int J Legal Med. 2006;120:241-5.
  • Fuke C, Miyazaki T, Arao T, et al. A fatal case considered to be due to cardiac arrhythmia associated with butane inhalation. Leg Med (Tokyo). 2002;4:134-8.
  • Novosel I, Kovačić Z, Gusić S, et al. Immunohistochemical detection of early myocardial damage in two sudden deaths due to intentional butane inhalation. Two case reports with review of literature. J Forensic Leg Med. 2011;18:125-31.
  • De Naeyer AHRR, de Kort SWK, Portegies MCM, et al. Myocardial infarction in a 16-year old following inhalation of butane gas. Ned Tijdschr Geneeskd. 2011;155:A3443.
  • Sen A, Erdivanli B. Cardiac arrest following butane inhalation. Anesth Essays and Res. 2015;9:273-5.
  • Grigorov V, Grigorov M, Grigorov E, Nocheva H. Butane-induced acute global myocardial ischemia without coronary artery pathology. Oxf Med Case Reports. 2020;2020:omaa118.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Adli Tıp
Bölüm Özgün Makaleler
Yazarlar

Ahmet Sedat Dündar 0000-0002-4029-2613

İsmail Altın 0000-0001-7185-2620

Yayımlanma Tarihi 19 Ekim 2023
Kabul Tarihi 13 Eylül 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 5 Sayı: Supplement (1) - Innovations in Medicine and Healthcare in the 100th Year of the Republic

Kaynak Göster

AMA Dündar AS, Altın İ. A Case Series of Butane Intoxication Fatalities in the Southeastern Anatolia Region of Türkiye. Med Records. Ekim 2023;5(Supplement (1):138-43. doi:10.37990/medr.1343983

 Chief Editors

Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Turkey

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Turkey

E-mail: medrecsjournal@gmail.com

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