title: Polyacrylamide hydrogel pulmonary embolism--A fatal consequence of an illegal cosmetic vaginal tightening procedure: A case report.
abstract: Vaginal tightening is a kind of esthetic surgery aimed at enhancing sexual satisfaction during intercourse. Although the injective vaginal tightening procedure is informal, there are already some reports of its application. But pulmonary embolism is a really rare therapeutic complication of this procedure. We report a case of death due to the non-thrombotic pulmonary embolism as a consequence of illegal cosmetic vaginal-tightening procedure using polyacrylamide hydrogel. A 34-year-old woman was hospitalized with paroxysmal abdominal cramps and diarrhea as initial symptoms, while she concealed the genital cosmetic surgery history. Respiratory distress presented only 1.5h before she died. The result of autopsy revealed the cause of death as pulmonary embolism due to the hydrogel which was injected into her vaginal wall. The emboli were confirmed as polyacrylamide hydrogel by Alcian-blue stain and the Fourier transform infrared scanning. It is suggested that pulmonary embolism should not be discarded in the expertise of deaths following cosmetic implant surgeries. It broadens our understanding about death associated with esthetic genital procedures and informs clinicians and medical examiners of the potential death of this type. And detailed investigations of previous medical and surgical history will always play a critical role in the certification of cause of death.
authors.affiliation: Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China. Electronic address: gerichtsarzt@hotmail.com.
authors.forename: Yijie
authors.initials: Y
authors.lastname: Duan
authors.affiliation: Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China. Electronic address: lyre2008@126.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Public Security of Hubei Province, No.181 Xiongchu Avenue, Wuhan, 430070, PR China. Electronic address: lishangxun@gmail.com.
authors.forename: Shangxun
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China. Electronic address: szomult@sina.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China. Electronic address: jingjunx@126.com.
authors.forename: Jingjun
authors.initials: J
authors.lastname: Xing
authors.affiliation: Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China. Electronic address: 18707165089@163.com.
authors.forename: Wenhe
authors.initials: W
authors.lastname: Li
authors.affiliation: Central Hospital of Zibo, No. 54 Gongqingtuan West Road, Zibo, 255036, PR China. Electronic address: soul_jaejin_2000@163.com.
authors.forename: Xinmei
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Forensic Medicine, Huazhong University of Science and Technology, Tongji Medical College, No. 13 Hangkong Road, Hankou, Wuhan, 430030, PR China. Electronic address: zhouyiwu@outlook.com.
authors.forename: Yiwu
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000180:Acrylic Resins / Q000009:adverse effects*; D000282:Administration, Intravaginal; D000328:Adult; D003357:Cosmetic Techniques / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D011655:Pulmonary Embolism / Q000139:chemically induced*; D014621:Vagina / Q000601:surgery*
chemical_list: D000180:Acrylic Resins; C016680:polyacrylamide gels
keywords: Polyacrylamide hydrogel; Pulmonary embolism; Therapeutic complication; Vaginal tightening