Post-mortem evaluation of drowning with whole body CT

Plaetsen, Sarah Vander; Letter, Els De; Piette, M; Parys, G van; Casselman, Jan; Verstraete, Koenraad

doi:10.1016/j.forsciint.2015.01.008

Cited by 43 publications

(13 citation statements)

References 19 publications

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“…While autopsy performance affords external and internal access to much of the anatomy to assess for findings of drowning, postmortem whole body computed tomography (WBCT) has been shown to be increasingly useful in the noninvasive documentation of these findings (51). Excessive fluid and sedimentous material in the sinuses and cavities of the head and chest, oropharynx, lungs, stomach, and small intestine have been identified in drownings.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Drowning Deaths: A Practical Review

Armstrong

Erskine

2018

Academic Forensic Pathology

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Drowning, which typically involves a watery environment, remains a serious public health concern claiming an estimated 362 000 lives per year worldwide across all socioeconomic classifications and has remained under close observation by the World Health Organization and its signatories. A significant number of water-related deaths are attributed to accidental drowning, while a smaller but still significant number represent suicidal or homicidal drowning. Others involve a combination of drowning precipitated by injury, intoxication, or environmental extremes. Still others involve victims that die from injury, intoxication, or a natural disease entity of such significance as to preclude the drowning process, while near or in water. While there may be an initial presumption that all water-related deaths are accidental drownings, other possibilities must be considered in the investigation of these types of deaths, as drowning as a cause of death is a diagnosis based on the exclusion of other potential causes. The coordinated investigative efforts of multiple agencies and disciplines are required not only for the designation as drowning as the cause of death but also for death certification. The ongoing analysis and dissemination of data generated from all levels of investigation augment our understanding of the impact on public health and safety, guiding allocation of monetary and educational resources in an effort to prevent further mortality and disability.

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Section: Discussionmentioning

confidence: 99%

Investigation of Drowning Deaths: A Practical Review

Armstrong

Erskine

2018

Academic Forensic Pathology

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“…Differentiating lung pathology with PMCT by means of pulmonary patterns has not been described in harbor porpoises and only infrequently in other cetacean species [ 4 , 27 ]. Several studies in the field of human forensic imaging identified distinct PMCT pulmonary patterns and have tried to correlate these to specific pulmonary pathology confirmed with conventional autopsy [ 16 , 17 , 38 , 40 , 41 , 42 , 43 , 44 , 45 , 46 ]. These studies repeatedly reported autopsy-confirmed PMCT ‘drowning’ lung changes represented by a mosaic pattern of centrolobular distributed, patchy to nodular ground glass opacities, although no consistent correlation between PMCT lung patterns and autopsy-confirmed drowning could be made.…”

Section: Discussionmentioning

confidence: 99%

Post-Mortem Computed Tomography Pulmonary Findings in Harbor Porpoises (Phocoena phocoena)

Kuijpers

Schalkwijk²,

IJsseldijk³

et al. 2022

Animals

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The application of whole-body post-mortem computed tomography (PMCT) in veterinary and wildlife post-mortem research programs is advancing. A high incidence of pulmonary pathology is reported in the harbor porpoise (Phocoena phocoena). In this study, the value of PMCT focused on pulmonary assessment is evaluated. The objectives of this study were to describe pulmonary changes as well as autolytic features detected by PMCT examination and to compare those findings with conventional necropsy. Retrospective evaluation of whole-body PMCT images of 46 relatively fresh harbor porpoises and corresponding conventional necropsy reports was carried out, with a special focus on the respiratory tract. Common pulmonary PMCT findings included: moderate (24/46) to severe (19/46) increased pulmonary soft tissue attenuation, severe parasite burden (17/46), bronchial wall thickening (30/46), and mild autolysis (26/46). Compared to conventional necropsy, PMCT more frequently identified pneumothorax (5/46 vs. none), tracheal content (26/46 vs. 7/46), and macroscopic pulmonary mineralization (23/46 vs. 11/46), and provided more information of the distribution of pulmonary changes. These results indicate that PMCT adds information on pulmonary assessment and is a promising complementary technique for necropsy, despite the frequent presence of mild autolytic features.

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“…Drowning is a diagnosis of exclusion and therefore, a complete autopsy is warranted in most cases. A PMCT can be used to supplement the autopsy (44) confirming some nonspecific features seen in bodies found in water, such as foreign debris in the airways or gastrointestinal tract (45). PMCT can also be useful to document injuries or foreign bodies that may suggest the body was dumped in the water rather than drowned.…”

Section: Apparent Drowning (Also Known As Bodies Found In Water)mentioning

confidence: 99%

Utilitarian Aspects of Postmortem Computed Tomography

Matshes

Snyder

Andrews

2015

Academic Forensic Pathology

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Computed tomography has been used in clinical medicine for decades, but only recently introduced into the forensic pathology setting. The reasons for the slow adoption of this technology into the autopsy suite are various, including concerns about funding, infrastructural maintenance, training, competency, and scope of utilization. Practical experience in a busy statewide medical examiner department confirmed the utility of this technology as a part of daily practice. The impact of postmortem computed tomography (PMCT) on casework can be stratified into three broad groups: where PMCT 1) supplants invasive autopsy, 2) supplements invasive autopsy, or 3) has limited or no potential for impact on practice. A detailed understanding of the practical uses of this science is important for the practicing forensic pathologist so as to guide decisions about the ways in which PMCT can be implemented within their own institutions and utilized on a daily basis. Dramatic changes in personal and institutional practice trends can be observed once forensic pathologists are comfortable with the evaluation, documentation, and interpretation of PMCT data. Examples of potential paradigm shifts include the performance of only external examination and PMCT instead of invasive autopsy in many cases of motor vehicle fatalities, suicide with violence, and broad categories of death due to natural disease. Over time, the authors believe that the PMCT will become one of the fundamental tools in the forensic pathologist's toolkit.

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Post-mortem evaluation of drowning with whole body CT

Cited by 43 publications

References 19 publications

Investigation of Drowning Deaths: A Practical Review

Investigation of Drowning Deaths: A Practical Review

Post-Mortem Computed Tomography Pulmonary Findings in Harbor Porpoises (Phocoena phocoena)

Utilitarian Aspects of Postmortem Computed Tomography

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