Case 1, image 1: There is edema, granulation tissue, necrosis, submucosal inflammation and formation of a pseudomembrane.

Case 1, image 2: A closer look at the injured epithelium with overlying fibrinous debris.

This is an interesting case as it emphasizes the importance of obtaining a good medical history and illustrates the thought process in determining cause and manner of death.

This 21 year old obese individual was admitted to the hospital due to complications of chronic alcohol abuse and required intubation during his stay. He was discharged 5 days prior to his death and complained of shortness of breath plus pain in his throat; however, he declined to seek additional medical care. On the day of his death, he was witnessed to grab his throat prior to collapsing. At autopsy, there was significant necrosis and narrowing of his trachea. Since a difficult intubation likely caused the inflammation and narrowing in his trachea and intubation was necessary to treat his chronic alcoholism, the medical examiner stated that this individual ultimately died of complications of chronic alcoholism. Contributing factors included to obesity and hypertension.