Cases reported "Asphyxia"

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1/4. Analytical investigations in a death case by suffocation in an argon atmosphere.

    A 31-year-old engineer was found dead in a reaction vessel (diameter 0.8 m, height 1.8 m) of a bulb factory some minutes after he had entered it for repair work. resuscitation attempts with artificial respiration were unsuccessful. Despite autopsy and usual toxicological analyses, no cause of death could be found. Since in the normal production process, argon was used as a protecting gas, the possibility of suffocation in an argon atmosphere was investigated. This was rendered more difficult because of the natural content of 0.93 vol.% argon in air and since the excessive argon could have been removed by the resuscitation attempts. Gas samples from larynx, esophagus, bronchi, and stomach, separated blood samples from both ventricles of the heart and from the vena iliaca externa as well as tissue samples from lung and liver were collected during autopsy into headspace vials in such a way that the loss of gas and a dilution by surrounding air was avoided as far as possible. The samples were analyzed by headspace GC-MS. The abundance of Ar (m/z = 40) was used for quantification with N2(2 ) (m/z = 14) as internal standard. The following argon concentrations were measured (mean values, case under investigation/comparison cases): gas from larynx 1.79/0.96 vol.%, stomach gas 1.58/0.89 vol.%, heart blood (left ventricle) 7.2/2.7 microg/mL, heart blood (right ventricle) 5.8/2.7 microg/mL, blood from vena iliaca externa 3.6/2.7 microg/mL. A clearly increased concentration was also found in lung tissue, whereas in liver tissue no significant difference in comparison to other cases was measured. From the results, it follows that the deceased inhaled an increased amount of argon a short time before death. The concentrations are consistent with asphyxia and subsequent resuscitation attempts. They cannot be explained by a long-term inhalation of an atmosphere enriched with argon before the incident as it is likely to have occurred in this factory hall.
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ranking = 1
keywords = esophagus
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2/4. Multiple synchronous fibrovascular polyps of the hypopharynx.

    PURPOSE OF THE STUDY: To evaluate the clinical, radiological presentation and surgical management of fibrovascular polyps of the hypopharynx. methods: Retrospective medical analysis of a case report. We report the case of a 66-year-old man, who presented with an incarcerated left inguinal hernia, vomiting and regurgitation of a large mass into the oral cavity resulting in syncope. MRI and cine-esophagram demonstrated a large mass in the cervical esophagus. At the time of herniorrhaphy, endoscopy revealed an 11.8-cm hypopharyngeal mass that completely obstructed the oropharynx. RESULTS: The airway was secured by tracheostomy and the lesion was subsequently removed via open pharyngotomy. Postoperatively, a second polyp was found ball-valving into the airway, and an endoscopic resection was performed prior to decannulation. Histopathology of both lesions confirmed the diagnosis of a fibrovascular polyp. CONCLUSION: Fibrovascular polyps are rare benign intraluminal esophageal lesions resulting in mild symptoms of dysphagia that may also cause significant morbidity such as syncope and asphyxia. This is the first report of synchronous fibrovascular polyps of the hypopharynx.
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ranking = 1
keywords = esophagus
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3/4. Asphyxiation caused by giant fibrovascular polyp of the esophagus.

    Giant fibrovascular polyps of the esophagus are rare, benign, "tumorlike" lesions that typically present as large pedunculated growths arising in the cervical esophagus. The predominant histologic component of these lesions is variable, often resulting in misdiagnosis. Clinically, these polyps present with nonspecific symptoms and are often undiagnosed or misdiagnosed until they are significant in size. diagnosis is best made by upper endoscopic evaluation; surgical excision is the definitive treatment. Although rare, asphyxia resulting from obstruction of the glottis is the most serious complication. We describe a case of asphyxiation caused by laryngeal occlusion by a giant esophageal polyp and we provide a review of the literature.
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ranking = 6
keywords = esophagus
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4/4. Sudden asphyxial death due to a prolapsed esophageal fibrolipoma.

    Fibrolipomas of the esophagus are extremely uncommon benign tumors. Accurate diagnosis and resection are essential, due to their tendency to become impacted and obstruct the airway. The case is presented of a 56-year-old man who died suddenly of asphyxia because of upper airway obstruction by a prolapsed fibrolipoma of the esophagus.
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ranking = 2
keywords = esophagus
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