Esophageal rupture through extreme sadomasochistic practice

Abstract

We report the case of a woman in her thirties who suffered an esophageal rupture while participating in extreme sadomasochistic practices. After herself seeking help in a hospital for complaints alleged to be from a fall, she was initially diagnosed with several broken ribs and a pneumothorax. The cause of the pneumothorax was later discovered to be an esophageal rupture. When confronted with this atypical injury for a fall, the woman admitted to have accidentally swallowed an inflatable gag, which her partner had afterwards inflated. In addition to the esophageal rupture, the patient also had numerous other externally visible injuries of various ages, reportedly also from sadomasochistic acts. Although an in-depth police investigation was conducted and a "slave contract" was found, the woman's consent to the extreme sexual practices performed by her life partner could not be substantiated conclusively. The man was convicted for intentional infliction of serious as well as dangerous bodily injury and sentenced to a long term in prison.

Keywords: BDSM; Esophageal rupture; Mutilation; Sadomasochism; Sexual assault.

Fig. 1

a, b Skin on chest and lower back (left image) and skin on left breast (right image), with partially missing mammilla, scarred areola, and burns, most likely from cigarettes

Fig. 2

Discolorations, in part like tram-line bruises on thighs and buttocks