English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Plus monthly

Global: Zendy Tools annual

Global: Zendy Tools monthly

Global: Zendy Free Plan

Complete and abrupt upper airway obstruction by a bolus of food, with sudden onset of symptoms simulating acute myocardial infarction was described as ‘Café coronary’ in early 60s. Victims are speechless and breathless; thus, without assistance (e.g.Heimlich manoeuvre) they will die. A typical ‘café coronary’ was an obese middle aged man dying, while eating having a chest pain, with eye witness accounts of ‘choking on a piece of meat’ which was hurriedly eaten. Though various theories were postulated at that time regarding the mechanism, later studies showed that multiple factors could be associated. We report a death of an alcoholic with a history of ischemic heart disease found with a bolus of food lodged at the pharynx and larynx. Case Report 51 year-old male after having 11⁄2 bottles of illicit liquor, quarreled with the wife and left home, was found dead two (2) hours later in a partly built house. The examination of the scene revealed half a bottle of alcohol, a partly consumed loaf of bread, a beef curry and a roasted chicken thigh beside. Autopsy revealed obstruction of the mid larynx with a piece of bread, mild laryngeal oedema, myocardial fibrosis, 80% narrowing of the anterior descending artery and a liquor smell from stomach. The toxicological screening revealed 200mg/dlethyl alcohol in the blood, while histology revealed fibrosis of the myocardium. Conclusion Although obstruction of the airway with a food bolus was the apparent cause of death at autopsy, the high blood alcohol level with myocardial fibrosis pauses questions regarding the mechanism of death i.e. which caused which? Therefore, a forensic pathologist should not be hurried to arrive at conclusions during the autopsy without further investigations.

Medical negligence and malpractice litigations in Sri Lanka: why it is a tip of an iceberg?