Chew before swallowing, say AIIMS experts after man chokes on momo

Experts at the All India Institute of Medical Sciences (AIIMS) in New Delhi issued a ‘swallow with care’ warning after reporting a rare case of a man dying from choking on a dumpling.

AIIMS forensic experts said momos, a popular street food, have a slippery and soft surface which can cause choking and even death if swallowed without chewing properly.

According to the AIIMS report, the man who was in his early 50s and drunk, was brought dead to AIIMS from South Delhi. Police investigations revealed he was eating at a shop when he suddenly collapsed and fell to the ground.

A post-mortem, using CT scan, found a dumpling lodged in the upper airway or the opening of the windpipe, leading doctors to conclude he died from choking on a momo.

The findings have been published in the Journal of Forensic Imaging in its latest edition.

“These findings are very important for medicolegal opinion but could be only done by digital coaxial tomography (CT scan). It can’t be detected in traditional visual postmortem examination,” Dr Sudhir Gupta, head of forensic department at AIIMS told Mint.

In medical terms, choking is a condition where there is an obstruction in the airway at any place between the pharynx and bifurcation of trachea.

Whenever a person eats anything that is too large to gain access into the food pipe and accidentally slips into the wind pipe, then it can lodge in the posterior hypopharynx (the bottom part of the tube that leads to the food pipe and wind pipe), resulting in blockage of the respiratory tract.

“The steamed momos are one of the favourite street foods in Delhi. Momos have a slippery soft surface which can cause choking which can also be fatal if swallowed without properly chewing. In this particular case, the cause of death was concluded as neurogenic cardiac arrest due to choking of momos which was found to be located at the laryngeal inlet,” said Dr Abhisehk Yadav, additional professor at forensic department at AIIMS, author of the report.

“The size of a dumpling is 5x3cm which is quite a big size and people should be aware when eating such type of food. Whenever such incidents happen, eye-witnesses should immediately perform Heimlich manoeuvre- a first aid medical procedure which is used to treat upper airway obstructions by foreign objects,” Yadav added.

The Heimlich procedure or abdominal thrust involves standing behind the person who is choking (the patient must also be stood), wrapping your hands around their waist, making a fist and repeatedly pushing the fist inwards until the food is expelled.

“Life-saving measures like cardiopulmonary resuscitation are of no use in such cases as the air given to the person can’t reach the lungs due to the obstruction at the laryngeal inlet by a foreign object, i.e. momo in this case,” said Dr Karthi Vignesh Raj K, a forensic expert at AIIMS.

AIIMS introduced the virtual autopsy procedure last year. More than 1,000 autopsies have been completed so far using the technology.