A rectal foreign body with giant bladder stone; An autopsy case of unusual autoerotic death

A man in his 60 s, who had experienced sustained abdominal pain intermittently for three years, lost consciousness and was transferred to an emergency hospital, where he was pronounced dead. In the forensic autopsy, a giant bladder stone measuring 6.5 × 6.0 × 4.0 cm was found adhering to an aluminum eyeliner that penetrated the anterior wall of his rectum. This might have induced pyelonephritis in the left kidney, resulting in sepsis. The deceased may have inserted the eyeliner for sexual stimulation. However, the eyeliner did not injure the peritoneum and no peritonitis occurred, which probably prevented acute sepsis immediately after insertion. The exact time of penetration was undetermined; however, the rectal foreign body may have been retained for three years. This case suggests that sexual activity should be considered a possible manner of death, even if it took place several years previously. • The rectum was penetrated by an eyeliner with a giant bladder stone 6.5 cm in diameter. • The cause of death was pyelonephritis caused by the rectal penetration. • The rectal foreign body might have been retained for three years. • The rectal foreign body was inserted by the patient for autoerotic action. • This case indicated late onset complication of rectal injury.