Choking accidents: An autopsy review

Aspiration of a foreign body is common in children and also in adult which can cause upper airway obstruction, leading to significant morbidity or mortality. Choking on food and non-food objects has been one of the leading cause of accidental death among children. Candy, gum and coins are the objects responsible in two thirds of the non-fatal cases. The retrospective study was conducted in the dept of Forensic, Medicine University of Malaya. A total of 47 deaths caused by choking on foreign bodies had been subjected to autopsy at Department of Forensic, UMMC over a period of ten years (1^st January 1996 to 31^st December 2005). The detailed analysis of these cases was based on the medical records and the evaluation of autopsy reports. The majority of the victims were male (n=37, 78.7%) as compared to female (n=10, 21.3%). Chinese showed the highest percentage (n=17, 36.2%), followed by Malay (n=12, 25.5%), and Indian (n= 9, 19.1%). Other races such as, Indonesian, and orang asli accounted for 9 cases (19.1%). Commonest age group involved was 0–5 years (n=18, 38.3%), followed by 21–30 year (n=10, 21.3%), 31–40 year (n= 7 cases 14.9%), 41–50 year (n= 5, 10.6%), 51–60 year (n=4 8.5%), and 16–20 year (n= 2, 4.3%). There were many causes for choking. Obstruction of the airways with food bolus was the most common cause (n=15, 31.9%), followed by aspiration of blood (n=12, 25.4%), others (choking on sand and neurological disorder) (n= 11, 23.4%) and aspiration of gastric content (n= 9, 19.1%). This study demonstrates that food is the most common cause of choking especially in 0–5 years old group children. Chinese (36.2%) was the highest ethnic group, followed by Malay (25.5%), Indian (19.1%) and other races (Indonesian and orang asli) (n=9, 19.1%). The common sites for obstruction was trachea, right bronchus and bronchioles.