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This is the smiling face of a five-year-old boy sitting in front of his chocolate birthday cake just moments before he sucked in a balloon and choked to death.

The tragic photo shows William Gabriel de Souza Lopes with his mother and siblings and his cake on the table in front of him at the family home in Porto Belo which is a municipality in the state of Santa Catarina in southern Brazil.

Paramedics met the horrified family as they rushed William to hospital.

They suspected the worst as the young boy’s lips had already turned blue and his pupils were not moving.

Still hoping for the best despite the child being unresponsive, the paramedic crew spent about 45 minutes resuscitating the boy.

They removed the balloon as quickly as they could but sadly nothing could be done to revive him.

The crew still refused to give up on poor William and drove him to hospital, but medics were only able to confirm his death.

He had suffered a cardiac arrest due to asphyxiating on the balloon.

Locals were heartbroken by the news, with the martial arts school William attended cancelling classes as a tribute.

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