Psychotic and Anatomical Defects of Choking: Case Report

Abstract

eath caused by choking occurs when food or foreign bodies block the respiratory tract. In the autopsy of choking cases, diagnosis is made through detecting a foreign body in the airways or determining the findings of asphyxia. If any specific reasons of death cannot be determined during the autopsy, the possibility of choking is taken into account. There are a lot of risk factors that cause choking. These wide range risk factors are swallowing large amounts of food, decayed or missing teeth, consumption of alcoholic beverages, cerebrovascular diseases, dementia, Parkinson's disease, schizophrenia, taking sedative or antipsychotic drugs.1 It is indicated that people diagnosed with mental illnesses are 8-20 times more likely to choke than the other people, and antipsychotic drugs which are taken by people with mental illnesses increase the risk of choking. 2,3 In this study, a case of a woman who was schizophrenic Turkiye Klinikleri J Foren Med 2015;12 (1) 33Psychotic and Anatomical Defects of Choking: Case Report A AB BS ST TR RA AC CT T Death caused by choking occurs when food or foreign bodies block the respiratory tract. This study aims reporting a death case of a 62-year-old schizophrenic woman who died after a piece of meat blocked her airways. We found out during the autopsy that meat which was found in oesophagus blocked larynx completely. Furthermore, it was observed that cervical hyperostosis (involving 5 th cervical vertebrae) narrowed upper oesophagus. Antipsychotic medications were detected in the toxicological analyses of blood and bile. This study was aimed to indicate that choking is caused not only by psychotic reasons but also by antipsychotic medications and cervical pathology. Moreover, these risk factors' causing death was also discussed with literature in this study.K Ke ey y W Wo or rd ds s: : Airway obstruction; schizophrenia; death, sudden; drug effects Ö ÖZ ZE ET T Tıkanma sonucu meydana gelen ölüm yabancı cisim veya gıda parçalarının hava yollarını tıkaması sonucu oluşmaktadır. Bu çalışmada 62 yaşında şizofreni hastası kadının büyük bir et parçasının hava yollarını tıkaması sonucu ölüm vakası rapor edilmiştir. Otopsi sırasında özofagus girişinde kalan büyük bir et parçası larinks hava yolu girişini tamamen tıkamış bir şekilde bulunmuştur. Aynı zamanda servikal 5. vertebrada (C5) bulunan hiperosteotik formasyonun özofagus girişini daralttığı izlenmiştir. Kan ve safranın toksikolojik analizlerinde antipsikotikler grubunda bulunan ilaçlar tespit edilmiştir. Tıkanmanın sadece psikiyatrik etkilerden değil antipsikotik ilaç kullanımından ve servikal patolojilerden de kaynaklanabildiği, bu risk faktörlerinin ölüme katkılarını literatür eşliğinde tartışmayı amaçladık.A An na ah ht ta ar r K Ke el li im me el le er r: : Havayolu tıkanıklığı; şizofreni; ölüm, ani; ilaç etkileri T Tu ur rk ki iy ye e K Kl li in ni ik kl le er ri i J J F Fo or re en n M Me ed d 2 20 01 15 5; ;1 12 2( (1 1) ): :3 33 3--6 6