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A Fatal Outcome of Pica Syndrome

An Unusual Case of Delayed Mortality

Bogdanovic, Milenko MD*; Alempijevic, Djordje MD, PhD*; Curcic, Djordje MD; Durmic, Tijana MD*

The American Journal of Forensic Medicine and Pathology: September 2018 - Volume 39 - Issue 3 - p 261–263
doi: 10.1097/PAF.0000000000000409
Case Reports

We present the case of a 42-year-old man, with a medical history of schizophrenic psychosis, who was found dead on the floor of his bedroom. At the autopsy, a bottle lid with a notched edge was found in the lower pharynx, partially obstructing the larynx and thus keeping the epiglottis in an open position. Airway obstruction was caused by edema and inflammation of the surrounding tissue. After removal of the foreign body, the tissue of the larynx was left with an impression of the bottle lid. The adjacent mucosa was swollen, hyperemic, partly necrotic, and covered with fibrin deposits. Also, foreign bodies were found in the stomach. The histological analysis of the hypopharynx showed severe nonspecific inflammation and necrosis of epithelium. The cause of death was a complication of subacute laryngeal obstruction caused by a foreign body.

From the *Institute of Forensic Medicine “Milovan Milovanovic,” School of Medicine, University of Belgrade; and

Clinic for Mental Disorders “Dr Laza Lazarevic,” Belgrade, Serbia.

Manuscript received January 12, 2018; accepted April 3, 2018.

The authors report no conflict of interest.

Reprints: Milenko Bogdanovic, MD, Institute of Forensic Medicine “Milovan Milovanovic,” School of Medicine, University of Belgrade, 31a Deligradska str, 11000 Belgrade, Serbia. E-mail:

© 2018 by Lippincott Williams & Wilkins.