Pediatric autopsy case of asphyxia due to salmon egg (ikura) aspiration

Abstract

Here we report an autopsy case of asphyxia due to aspiration of a salmon egg (ikura) into the airway. The patient was a 19-month-old girl. During breakfast, she put salmon eggs into her mouth, and began to walk. She slipped, fell down, and collapsed. She was pronounced dead following 2 h of resuscitation. The body was autopsied 28 h after death. The gastric contents consisted of rice, orange sections, and white salmon eggs. The lungs were deeply congested and over-inflated. In the right lung, areas of atelectasis in the upper and middle lobes were seen. A yellow salmon egg (8 mm in diameter) was found in the trachea. Although fish eggs are consumed throughout the world, reports of this sort are limited. The aspiration of fish eggs is under-acknowledged and underreported. The importance of preventive measures needs to be emphasized to parents and caregivers.

National estimations of airway foreign bodies in children in the United States, 2000 to 2009

“…Death, unfortunately, may result after foreign body aspiration, which underscores the importance of recognition and prompt treatment. 9,10 Fortunately, our data and results suggest that the associated mortality did not increase in incidence over the near-decade spanning between 2000 and 2009.…”

“…As revealed by our investigation of the years between 2000 and 2009, it appears that the extrapolated national mortality rate with children with a diagnosis of an airway foreign body was 2.75% (standard error =0.18%). Death, unfortunately, may result after foreign body aspiration, which underscores the importance of recognition and prompt treatment . Fortunately, our data and results suggest that the associated mortality did not increase in incidence over the near‐decade spanning between 2000 and 2009.…”

Öldüren fasulyeler; Fasulye tohumu aspirasyonu sonucu iki asfiksi olgusu.

“…Foreign body aspiration is still the most common cause of accidental death among children under the age of three years (2). Foreign body aspiration occurs typically when a child is eating or playing and expresses sudden respiratory distress (1,3). Hard and round food items should be regarded as potential aspiration hazards e.g.…”

“…Besides radiography and bronchoscopy, a CT scan can be of special value to visualize the foreign body both ante-and post-mortem (3). The reason for avoidance of items with a choking hazard is that children have underdeveloped abilities for chewing and swallowing, high rate of ventilation, immature protective reflexes of the upper aero-digestive tract, and narrow airway, which may not permit easy expulsion of foreign objects (1). The lack of molar teeth decreases their ability to masticate food.…”

Tracheal foreign body-Importance of early diagnosis

“…One of the locations with the highest risk of vital commitment is the larynx and trachea, since complete obstructions can lead to suffocation, stop cardiorespiratory and even death, being between 0.4% to 1% mortality refl ected by some bibliographic series [6,7], and recently documented a case of death in a patient of 2 years by asphyxia by salmon roe detected during the necropsy [8]. If the aspirated object not occluded by complete the tracheal orifi ce and there is no suspicion clear of the incident, as it happened in our case, the patient's symptoms may be confused with processes asthmatics, pneumonias or laryngeal affectations [3].…”