Aspiration Deaths Among Adults in Istanbul
DOI:
https://doi.org/10.17986/blm.2013181263Keywords:
adult, aspiration, death, autopsyAbstract
Massive aspiration of food is rare, but most common in people under the influence of alcohol or a drug and comatose patients who have impaired functioning of the central nervous system. The finding of small amounts of food material in the airway at autopsy does not indicate the true vital aspiration because of agonal or even early post-mortem overspills. Occlusion of the small airways, mainly the membranous and respiratory bronchioles, partial or total filling of bronchiolar lumen and the alveolar spaces with food or gastric content were typical morphologic findings.
In our 10 year retrospective study we presented the data of 21 male and 4 female cases with a final diagnosis of fatal aspiration in age from 23 to 78 years (45.43±14.61) from the records of Morgue Specialization Department of the Council of Forensic Medicine. 13 cases found death at the scene without an eyewitness. All deaths were accidental in manner except one homicide. Toxicological analysis revealed blood alcohol concentration levels between 161 and 339 mg/dL in 7 cases. Morphine metabolites, benzodiazepine and barbituric acid derivatives, toluene and acetone were detected in 5 subjects. Aspirated materials were food in 14 cases, chewing gum in 3 cases, gastric content in 7 cases and a fabric gag in one case.
The history, other evidence of external vomit on the clothing or immediate surroundings and toxicological analysis are by no means as significant as autopsy findings especially in cases of aspiration.
Key words : adult; aspiration; death; autopsy
Downloads
References
Gresham GA. Violent form of asphyxial death. In The Pathology of Trauma, Ed. Mason J.K. The Bath Press, Avon, 1993:204–213.
DiMaio VJ, DiMaio D. Forensic Pathology. CRC Press, Boca Roton, 2001.
Bockholdt B, Ehrlich E. Maxeiner H. Forensic importance of aspiration. Leg Med (Tokyo).2003;5:311-314. DOI: https://doi.org/10.1016/S1344-6223(02)00158-X
Berzlanovich AM, Muhm M, Sim E, Bauer G. Foreign body asphyxiation-an autopsy study. Am J Med. 1999;107:351-355. DOI: https://doi.org/10.1016/S0002-9343(99)00242-9
Delmonte C, Capelozzi VL. Morphologic determinants of asphyxia in lungs: a semiquantitative study in forensic autopsies. Am J Forensic Med Pathol. 2001;22:139–149. DOI: https://doi.org/10.1097/00000433-200106000-00006
Wick R, Gilbert JD, Byard RW. Café coronary syndrome-fatal choking on food: an autopsy approach. J Clin Forensic Med. 2006;13:135-138. DOI: https://doi.org/10.1016/j.jcfm.2005.10.007
Berzlanovich AM, Fazeny-Dörner B, Waldhoer T, Fasching P, Keil W. Foreign body asphyxia: a preventable cause of death in the elderly. Am J Prev Med. 2005; 28:65–69. DOI: https://doi.org/10.1016/j.amepre.2004.04.002
Dolkas L, Stanley C, Smith AM, Vilke GM. Deaths associated with choking in San Diego county. J Forensic Sci. 2007;52:176–179. DOI: https://doi.org/10.1111/j.1556-4029.2006.00297.x
Haugen RK. The café coronary. Sudden deaths in restaurants. Jama.1963;186:142–143. DOI: https://doi.org/10.1001/jama.1963.63710020011017
Jacob B, Huckenbeck W, Barz J, Bonte W. Death, after swallowing and aspiration of a high number of foreign bodies, in a schizophrenic woman. Am J Forensic Med Pathol. 1990;11:331-335. DOI: https://doi.org/10.1097/00000433-199012000-00014
Downloads
Published
Issue
Section
License
The Journal and content of this website is licensed under the terms of the Creative Commons Attribution (CC BY) License. The Creative Commons Attribution License (CC BY) allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed.
