Deaths Due to Choking: An Autopsy-Based Study

Choking is a form of asphyxia caused by an obstruction within the air passages. A record-based cross-sectional study involving 30 cases of choking deaths brought for autopsy to the Department of Forensic Medicine, Government T.D. Medical College, Alappuzha, Kerala, India, from 1 January 2013 to 31 December 2022. The commonest age group affected was 0–10 years (26.7%), and there was a male preponderance (73.3%). Time of occurrence aligned with the postprandial phases after the day’s major meals, especially dinner. 46.7% of the victims had pre-existing illnesses like coronary artery disease, seizure disorder, chronic liver disease, inguinal hernia, diabetes mellitus and hypertension. Out of the 20 cases where the choking event was witnessed, only four survived long enough to receive medical assistance prior to death. In 50% of the subjects, the level of obstruction was bronchioles, followed by the laryngeal inlet (33.3%). Choking material was food in 70% of the cases, and the non-food materials included denture, sand, rambutan seed, bottle cap, baby coconut and handkerchief. Lungs showed congestion and oedema in 31.3%, haemorrhages in 14.1%, emphysema in 9.4% and atelectasis in 6.3%. Cerebral oedema was noted in 26.6% of cases. The manner of death was mostly accidental.