Detection of Airway Obstruction Caused by Mochi in a Decomposed Body Using Postmortem CT

Postmortem CT (PMCT) is widely used in forensic investigations to determine the causes of death and is particularly effective in trauma cases and for detecting foreign bodies such as gas or metallic fragments. However, PMCT utility in cases of advanced postmortem changes remains poorly explored. We present the case of a woman in her 60s with a history of schizophrenia who was found in an advanced state of decomposition. PMCT revealed a high-density foreign body in the pharynx, with a CT value of 154.4 HU. During autopsy, a white object, approximately 5 cm in size, was discovered in the pharynx, which was later identified as a mochi, a traditional Japanese rice cake. This led to the conclusion that the cause of death was asphyxiation due to airway obstruction caused by a mochi. This case highlights the diagnostic potential of PMCT in cases of advanced decomposition, particularly for detecting airway obstruction caused by food. Further research and accumulation of such cases are essential to completely evaluate the utility of PMCT in forensic investigations involving advanced decomposition.