Background: The incidence of sudden death from food asphyxiation is relatively low. An older study of hospitalized adult patients, however, found food asphyxiation as a cause of death in 14 of 1,087 (1.3%) autopsies performed over 5 years. Those patients died suddenly, during or shortly after meals. Old age (12 of 14 were 64 y old), poor dentition, and sedation were notable risk factors. We believe that in our patient, apart from old age, her cough caused by the community-acquired pneumonia was an important factor contributing to foreign-body aspiration. Asphyxia from foreignbody aspiration in adults is uncommon, because items small enough to pass through the vocal cords are often too small to obstruct the main airway and cause asphyxia. Published reports of death or near death in adults due to foreign-body aspiration have generally been associated with altered consciousness, old age, or a rapidly expanding foreign body, such as a sucralfate tablet. The impactions in those cases were mainly at the main bronchus level. A broad range of aspirated foreign bodies has been reported, including food and organic items such as peanuts, vegetable seeds, and meat bone, and inorganic objects such as veil/scarf pins and pen caps. Food items are usually the aspirated foreign bodies in adults, especially the elderly. The literature on foreign-body aspiration in adults suggests 3 categories of risk factor. Chen et al postulated that in patients with respiratory comorbidities the increased risk of aspirating food items may be related to the raised respiratory rate, causing difficulty with swallowing. A blunting of protective reflexes secondary to hypercapnia may also play a role.

Foreign Body Aspiration