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A Very Unusual Accidental Mechanical Asphyxia of Choking with a Whole Solea Solea
Author(s) -
Busardò Francesco Paolo,
Mannocchi Giulio,
Pugnetti Paola,
Santurro Alessandro,
Maggiordomo Aldo,
Zaami Simona
Publication year - 2017
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/1556-4029.13261
Subject(s) - choking , asphyxia , autopsy , accidental , medicine , swallowing , rigor mortis , poison control , esophagus , forensic pathology , anatomy , surgery , anesthesia , medical emergency , physics , acoustics
The case here reported involves a schizophrenic 19‐year‐old girl under treatment with clotiapine, which was well tolerated except for a moderate dry mouth. The woman ingested a whole sole ( Solea solea ), which caused a very rapid death by choking. A complete autopsy was performed 24 h later, as well as histological and toxicological analysis. At autopsy, the sole was wedged in the esophagus causing a choking ab extrinseco. The fish had a length of 18 cm and a maximum width of 6 cm, weighing 188.7 g. Toxicological analysis detected 0.57 mg/L of clotiapine in blood, which falls within the therapeutic range. The peculiarity of this case is represented by two factors: one is the choking by fish and the second was the adverse affect caused by clotiapine, which induced a condition of dry mouth making the act of swallowing even more difficult, thereby contributing to a very rapid mechanical asphyxia and the death of the young woman.