Choking – a case report

DR.DEBARSHEE CHAKRABORTY POST GRADUATE TRAINEE, DEPARTMENT OF

FORENSIC MEDICINE AND TOXICOLOGY, GAUHATI MEDICAL COLLEGE, GUWAHATI.

DR.RAKTIM PRATIM TAMULIREGISTER, DEPARTMENT OF FORENSIC MEDICINE

AND TOXICOLOGY, TEZPUR MEDICAL COLLEGE, TEZPUR

DR. R.CHALIHA PROFESSOR & HOD,

DEPARTMENT OF FORENSIC MEDICINE AND TOXICOLOGY, GAUHATI MEDICAL COLLEGE,

GUWAHATI

Choking is a form of

asphyxia caused by an obstruction

within the air passages ,

usually between the pharynx and bifurcation of

trachea.

1. Sore –throat2. Hoarseness3. Respiratory

difficulty4. Unable to

speak or make any sound.

5. Cyanosed (blueness of lip/nail bed)

6. Coughing rapidly

7. Collapse

Signs and Symptoms

Univesal Sign for Choking

Accidental

Suicidal

Homicidal

Types of choking

1.Seen in very young, elderly, psychiatric patients or in the infirm.2.Seen commonly during crying & laughing.3.Under the influence of a drink, an anaesthetic or in epilepsy or in a state of insensibility.4.Infants regurgitating the clotted milk and in children rubber balloons, coins, marble etc inhalation during play.5.Tranquilizing drugs depressing the gag reflex.6.In head injuries , Vomiting can occur which may be inhaled. . 7.Impaction of large food bolus, blood and clothes in ENT operations, gauze packs etc.8.A blow to the front of neck.

Accidental choking

Suicidal choking

1.Its rare.2.Usually seen in

dementia or psychosis patients or in prisoners.

3.Mechanism: a foreign body is thrust into the throat.

Homicidal choking

1. Its very rare 2. Practicable only when the

victim is suffering from disability or disease

3. Used as a mode of infanticide4. Mechanism : stuffing a wad of

paper or cloth into the pharynx or larynx.

Cause Of Death in

Choking

Asphyxia Laryngeal spasmDelayed death due to

pneumonia , lung abscess or bronchiectasis

Cardiac Inhibition

History Of The Case

The present case which was brought by a local police station for medico legal autopsy to the

mortuary of GMCH , was of a young man of 29 years who reportedly mystrically found dead

one morning in his own bed by his family members. According to the history given by the family members they all took dinner together

the previous night and then he went to his room and slept. The next morning the family

members found him dead with vomiting all around the face and cloths after breaking the

door when the man did not open the door after repeated knockings.

External Examination

On external examination , the body was found to be of a male of average built with

closed eyes and partially open mouth with vomitus seen all

over the face , neck and cloths at places.

No injuries were found on external examination.

Internal Examination

Petechial hemorrhages were found over the surface at places and the chambers of heart are found to contain liquid blood.

Heart

The coronaries were found to be healthy and not obliterated .

Both the lungs were found to be congested and petechial hemorrhages were found over the surface at places.

Lungs

Larynx and trachea

Mucosa was found

to be congested and found to contain bolus of partially digested

food material.

The stomach mucosa was also congested and the cavity was found to contain partially digested food material.

The mucosa were also found congested and the cavity was found to contain partially digested food material.

stomach

Mouth and esophagus

The other organs were also found to be

congested.

Membranes and brain Subarachnoi

d hemorrhage

(SDH) is found to be

present over the occipital

area bilaterally

and the brain too

was found to be

congested.The scalp and skull all were found healthy without any injury.

Conclusion

Death was opined to be due to asphyxia as a result of Choking.

THANK

YOU…