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

Abstract

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.