ESOPHAGEAL FOREIGN-BODIES AS CHILD-ABUSE - POTENTIAL FATAL MECHANISMS

Foreign bodies being forced into the esophagus as a form of fatal chil d abuse is rare. A 4.5-month-old female infant presented to clinicians with respiratory distress. Several coins were recovered from the esop hagus. One month later, she was found dead in her crib. At autopsy, th ere were three coins in the esophagus. In addition, there were cutaneo us contusions of various ages, acute and partially healed fractures of the extremities, old aspirated foreign material in the lungs, and pul monary fat emboli. Although the fat emboli may have contributed to the death, several potentially fatal mechanisms from the esophageal forei gn 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, an d cardiac compression or airway occlusion by the introducing finger.