Nolte K B
Office of the Medical Investigator, University of New Mexico, School of Medicine, School of Medicine, Albuquerque 87131-5091.
Am J Forensic Med Pathol. 1993 Dec;14(4):323-6. doi: 10.1097/00000433-199312000-00010.
Foreign bodies being forced into the esophagus as a form of fatal child abuse is rare. A 4.5-month-old female infant presented to clinicians with respiratory distress. Several coins were recovered from the esophagus. One month later, she was found dead in her crib. At autopsy, there were three coins in the esophagus. In addition, there were cutaneous contusions of various ages, acute and partially healed fractures of the extremities, old aspirated foreign material in the lungs, and pulmonary fat emboli. Although the fat emboli may have contributed to the death, several potentially fatal mechanisms from the esophageal foreign bodies deserve consideration. These include vagal stimulation from esophageal distention, aspiration of swallowed fluids after esophageal obstruction, compression of the trachea or the heart by the coins, and cardiac compression or airway occlusion by the introducing finger.
异物被强行塞入食管作为一种致命的虐待儿童形式是罕见的。一名4.5个月大的女婴因呼吸窘迫被送至临床医生处。从食管中取出了几枚硬币。一个月后，她被发现死在婴儿床里。尸检时，食管中有三枚硬币。此外，还有不同时期的皮肤挫伤、四肢急性和部分愈合的骨折、肺部陈旧性吸入异物以及肺脂肪栓塞。尽管脂肪栓塞可能是导致死亡的原因之一，但食管异物的几种潜在致命机制值得考虑。这些包括食管扩张引起的迷走神经刺激、食管梗阻后吞咽液体的误吸、硬币对气管或心脏的压迫以及插入手指导致的心脏压迫或气道阻塞。
