Attached
INTRODUCTION
Choking refers to blockage of the upper airways by a foreign body. Death due to choking is not
uncommon in Sri Lanka especially among children due to lack of knowledge among parents.
When the fatal occlusion of upper airway is caused by a large pieces of food, it is called CafO
Coronary syndrome. Chocking most often occurs when food is not chewed properly. In this case
a child got choked a piece of apple while eating by himself.
CASE HISTORY
’ A piece of apple was given to one year arid two months old child by the mother at 2.00pm. Child
was allowed to eat by himself without supervision and mother suddenly heard a noise of coughing.
Assuming that the child had choked, she shouted. A neighbour held the child upside, down and
slapped on the back resulting expulsion of few pieces of apple. The child was pronounced dead
on admission at 2.45 pm. Autopsy revealed, 8 incisors in mouth. No injuries were found. At
larynx, a 3x2cm yellow solid particle was found. Histopathology and toxicology were
unremarkable. Cause of deatffwas ascertained as Choking.
CONCLUSIONS
Due to the presence of a compatible clinical history, establishment of an accidental circumstance^
demonstration of the impacted material in the airway at autopsy while excluding the risk factors,
the cause of death was ascertained as choking due to caf6 coronary syndrome. The use of nontouch dissection to identify the foreign body in-situ in such circumstances is highlighted. Lack of
supervision of the child and delay in rescue action would have contributed for the death.
