Appearance of gas collections after scuba diving death: a computed tomography study in a porcine model

Abstract

In fatal scuba diving accidents, offgassing appears early (starting from the first hour after death) in the venous system then spreads to the arterial system after about 3 h. The presence of intra-arterial gas is therefore not specific to barotrauma. To affirm a death by barotrauma followed by a gas embolism, a postmortem scanner should be conducted very early. Subcutaneous emphysema should not be mistaken as diagnostic criteria of barotrauma because it can be caused by the resuscitation maneuvers.

Injuries due to Asphyxiation and Drowning

“…Excess ('supersaturated') dissolved inert gas absorbed by tissue during diving before death can no longer reach the lungs after cardiocirculatory and respiratory activity ceases and is released from solution into the unperfused vascular system. Postmortem bubbles develop in all organs and tissues and have been observed experimentally by CT in the venous system starting from the first hour after death, spreading to the arterial system after about 3 hours, and being widely distributed by 8 hours (Laurent et al 2013). The extent of postmortem bubble formation will depend on depth-time exposure.…”

Lung density measurement in postmortem computed tomography: a new tool to assess immediate neonatal breath in suspected neonaticides

“…The immersion of a piece of liver is used as a control to avoid misinterpretation of the HT due to the presence of putrefaction gas [11]. The interest of this practice could be discussed, as PMCT is very efficient in evaluating the presence of intravascular gas due to putrefaction [11,20] or any other cause [21,22].…”

Sudden Death in a Diver: A Diagnostic Conundrum

“…2 Experiments on animals exposed premortem to recreational diving conditions and then scanned after death demonstrate that PMDA begins gradually, initially intravenously from the first hour postmortem, which then spreads to the arterial system after 2 to 3 hours and is very obvious by 8 hours. 19,20 Therefore, at 100 minutes postmortem, our PMCT is potentially liable to the effects of PMDA, largely on the venous side. Also, some authors advocate performing a whole-body PMCT as soon as possible after death in order to demonstrate gas in the intramuscular fascial layers, which is relatively specific for PMDA and not acute DCS, providing putrefaction gases are excluded.…”