Fatal tracheobronchial obstruction caused by a swallowed glove: a rare forensic case with postmortem CT-autopsy correlation.

BACKGROUND

Foreign body aspiration is a recognized cause of sudden death in elderly and neurologically impaired individuals. However, glove ingestion leading to fatal tracheobronchial obstruction is exceedingly rare.

CASE: A male in his 80s with advanced dementia was found unresponsive in his hospital bed. Resuscitation attempts, including video laryngoscopy, failed to detect any airway obstruction. Postmortem computed tomography (PMCT) revealed a well-defined tubular foreign body in the tracheal lumen, extending from the subglottic region to the carina and into the main bronchi. It demonstrated soft-tissue density with curvilinear margins and internal air, resembling the appearance of a folded rubber glove. Several tubular projections, similar to the fingers of a glove, extend into the main bronchi, causing nearly complete obstruction of the central airway. Autopsy confirmed asphyxia due to tracheobronchial obstruction by a plastic glove.

CONCLUSION

This case highlights the rare phenomenon of fatal glove ingestion in a cognitively impaired inpatient which was missed during clinical evaluation and resuscitation, emphasizing the value of PMCT in foreign body detection. It further underscores the vulnerability of elderly patients with dementia to both accidental and self-inflicted airway obstruction, stressing the critical importance of implementing preventive strategies in institutional care settings.