Drowning—post-mortem imaging findings by computed tomography

Abstract

The aim of this study was to identify the classic autopsy signs of drowning in post-mortem multislice computed tomography (MSCT). Therefore, the post-mortem preautopsy MSCT-findings of ten drowning cases were correlated with autopsy and statistically compared with the post-mortem MSCT of 20 non-drowning cases. Fluid in the airways was present in all drowning cases. Central aspiration in either the trachea or the main bronchi was usually observed. Consecutive bronchospasm caused emphysema aquosum. Sixty percent of drowning cases showed a mosaic pattern of the lung parenchyma due to regions of hypoand hyperperfused lung areas of aspiration. The resorption of fresh water in the lung resulted in hypodensity of the blood representing haemodilution and possible heart failure. Swallowed water distended the stomach and duodenum; and inflow of water filled the paranasal sinuses (100%). All the typical findings of drowning, except Paltau's spots, were detected using post-mortem MSCT, and a good correlation of MSCT and autopsy was found. The advantage of MSCT was the direct detection of bronchospasm, haemodilution and water in the paranasal sinus, which is rather complicated or impossible at the classical autopsy.

Injuries due to Asphyxiation and Drowning

“…In the lungs, a typical finding is ground-glass opacity with a mosaic pattern representing hypo-and hyperperfused regions. CT may assist in identification of bronchospasm and, in fresh water, haemodilution, which is impossible during a classic autopsy (Levy et al 2007;Christe et al 2008).…”

The Importance Of Virtopsy In The Forensic Autopsy

“…Otopsi ön-cesi çekilen postmortem ÇKBT, suda boğulmaya bağlı ölümlerin tanısında iyi bir görüntüleme ve belgeleme aracıdır (15).…”

CT-Scanning in Forensic Medicine

“…Pleural effusion and fluid in ventricle, duodenum and paranasal sinuses are also common findings. A reduced bronchial-arterial coefficient is a sign of bronchospasm (43). Reduction of the blood density (Houndsfield Units) in the right heart chamber is indicative of haemodilution (44).…”