Massive gas embolism in a child

  • Murilo Sérgio Valente-AguiarEmail author
  • Ricardo Jorge Dinis-OliveiraEmail author
Images in Forensics


A 16-month-old girl who was hospitalized with pneumonia and treated with antibiotics died after the nurse erroneously connected her intravenous left forearm catheter to the oxygen supply. Autopsy revealed an impressive gas embolism in the left subclavian and brachiocephalic veins, reduced crepitus and enlarged lung volume, and congestion of the meningeal vessels with some areas showing small air bubbles. Dilation of the right atrium and the right ventricle with efflux under pressure of large amounts of air bubbles were observed. The coronary arteries and veins were filled with air bubbles intercalated with segments containing blood. After exclusion of putrefactive artifacts as the source of such a large amount of gas in the body death was considered to be due to a massive air embolism. While embolisms are well recognized in adults, these cases are only infrequently encountered in forensic practice in younger decedents.


Massive gas embolism Child Neglect Iatrogenic Forensic autopsy 



Ricardo Dinis-Oliveira acknowledges Fundação para a Ciência e a Tecnologia (FCT) for his Investigator Grant (IF/01147/2013).


The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, and royalties.

Compliance with ethical standards

Conflict of interests

The authors declare that they have no conflict of interest. No writing assistance was used in the production of this manuscript.

Ethical approval

All procedures were performed according to the ethical and legal standards of the institution.

Informed consent

Not applicable.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Public Health and Forensic Sciences, and Medical Education, Faculty of MedicineUniversity of PortoPortoPortugal
  2. 2.Legal Medical Institute of Porto Velho, Civil Police of the State of RondôniaRondôniaBrazil
  3. 3.IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, Department of SciencesUniversity Institute of Health Sciences (IUCS), CESPU, CRLGandraPortugal
  4. 4.UCIBIO-REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of PharmacyUniversity of PortoPortoPortugal

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