Posterior Pharyngeal Wall Perforation Caused by Laryngeal Tube Suction: A Case Confirmed by Forensic Autopsy

Laryngeal tube suction (LTS) is widely used by emergency medical technicians for airway management in patients with out-of-hospital cardiac arrest, but reports of serious complications are limited. Here, we report a rare case of out-of-hospital cardiac arrest in which an LTS was inserted during resuscitation, and perforation of the posterior pharyngeal wall was confirmed by forensic autopsy. The present case is notable because the perforation site was directly visualized during an autopsy while the device remained in place. The case highlights important findings from both the emergency education and forensic perspectives. While the LTS offers the advantage of rapid blind insertion, it carries the risk of fatal complications, such as perforations or deviations from the insertion path. To prevent such perforations from occurring, some essential measures are required, including appropriate device size selection, recognition of resistance during insertion, and confirmation via capnography. Emergency medical personnel should be mindful of these risks during their clinical practice.