Death by autoerotic asphyxia: report of a case

Introduction: The kind of paraphilia in which sexual pleasure is reached through physical or moral pain it is define sexual masochism. A particularly dangerous kind is hypoxyphilia, that involves excitement by oxygen deprivation in various situations in which death is grazed or even reached. The fatal accidents from autoerotic practices are provoked with various modalities, but the more frequent ones are the strangling and the asphyxia due to the practice of “hanging” (autoerotic asphyxia or AEA) in course of masturbation in presence of pornographic material and other objects like locks and prosthesis. The accidental death usually occurs when the “emergency mechanism” used in order to produce the transitory hypoxia (ropes and fastenings, bags decreased on the ace or masks) or in order to reach suspension (bondage) deteriorates and does not alleviate the jam of the neck. Methods: A case of a Philippine 33-years-old man is reported: he was found dead in his home, supine on the bedroom floor between numerous photographies with a green rope still in tension knotted around his neck as a loop, ending with a metal buckle fixed in the axillary cavity with a black belt. This belt, from the inside of his left thigh, was overlapped near the inguinal region, and ended on the pavement between his left foot and his right knee. Another belt was hanging from the ceiling, and a portion of rope was tied to the child’s tricycle. Near the corpse was also recovered a knife approximately 30cm length, with a blade 17cm length. Results: The external necroscopic examination revealed right conjunctival petechiaes, haematic material on the lips, horizontal and oblique glottic furrow with bilateral abrasions, interrupted in left paramedian nucal region. The cadaverous dissection permitted to demonstrate bilateral haemorrhagic infiltration of the thyroid membrane and the cranial portion of pre-laryngeal muscles, plurifocal bilateral subpleural petechiaes and fluid blood. The cause of the death was identified in mechanical asphyxia from constriction of the neck by means of a rope. Conclusions: The illustrated case rappresent an “autoerotic fatality” in which the death is caused by autoerotic asphyxia. A significative role in the identification of cause of death is been played by the adequate reconstruction of crime scene: modalities of corpse discovery, objects founded near the body (ropes, belts, knife, tricycle and photographies)