Zum Erstickungstode beim Verschlu� der Atem�ffnungen durch Sand

Abstract

Death by Suffocation as a Result of Occlusion of the Respiratory Tract by SandSummary. Eleven cases are reported in which death occurred because of suffocation as a result of occlusion of the respiratory tract by sand (without thoracic compression: 3 cases) or being buried alive (8 cases). Two tables demonstrate the findings and circumstances in the events. Three cases are described in detail. A 22-year-old woman was manhandled by blows and kicks to the head and neck. She became unconscious and her head and neck were covered by a layer of sand so that she suffocated. A 42-year-old man was smothered, while unconscious, in a prone position with his face in the sand, after hard blows to the head by two culprits. A 17-year-old girl finally died by chocking. Previously the culprit had pressed her face into the ground, so that she aspirated particles of soil. The question of vital reactions during aspiration of sand was investigated by microscopic examination of the content of the air passage and by destroying parts of the lungs by sulphuric acid. Minimal aspiration of sand occurred in all cases. Although the postmortal remains were left in the ground, there was no postmortem penetration of sand into the air passage. Histological examinations were carried out to support the diagnosis of violent suffocation. In some cases, there were remarkable findings (mobilization of alveolar cells, hepatocelullar hydropic degeneration), but there were no typical or unanimous findings that pertained to all cases.

Zur lokalen Vitalreaktion nach Angriff gegen den Hals

“…Auch bei hoher Alkoholisierung (gmal > 2%0) waren Ver~inderungen dieser Art zu finden (in 5 F~illen), bei den 6 F~illen mit deutlicher Zellemigration lag allerdings in keinem eine h6hergradige Alkoholisierung vor: Hierbei handelt es sich um 4 aufgeklarte und zwei noch ungekl~rte F~ille, von denen zwei bereits vorgestellt wurden [24,29]. Zahlenm~igig land sich zwar keine Altersab-h~ingigkeit, nach dem Eindruck waren die Befunde bei jfingeren Individuen aber meist st~irker (gr6ger, an mehr Stellen in der Blutung) als bei sehr alten Personen.…”

Acute or chronic pulmonary emphysema? Or both?—A contribution to the diagnosis of death due to violent asphyxiation in cases with pre-existing chronic emphysema

“…However, the pattern of findings may also be very discrete. This might be especially the case if the victim was unable to defend him-or herself (e.g., in cases of physical superiority of the offender, intoxication of the victim, or physically frail victims like children or elderly [7][8][9][10][11]). Other reasons for missing skin or tissue findings, like Nina S. Mahlke and Stefanie Ritz-Timme have shared senior authorship hematoma or hemorrhages, may be very smooth, soft strangulation tools, or wearing gloves.…”

“…However, this conclusion was refuted by other authors, since this constellation of findings was also found in control groups, e.g., in cases of shock or resuscitation [ 26 , 27 ]. Several studies on human lung tissue described a significant increase in alveolar macrophages and giant cells, especially in protracted asphyxia [ 10 , 28 – 31 ]. Betz et al [ 32 , 33 ] and Grellner et al [ 34 ], conversely, described in their studies that there is no significant giant cell formation or alveolar macrophage proliferation in deaths by asphyxia, which could also be substantiated in 2019 by Gutjahr et al [ 27 , 35 ] (“pre-existence hypothesis”).…”

Fatal outcome of a sand aspiration

“…Most of the few cases reported so far share the common mechanism of being buried accidentally under sand, dirt, or gravel masses at construction sites [1][2][3][4], as the result of the collapse of sand tunnels [5,6], sand castles [7], and sand piles [1,8] or in the course of a vehicle accident [9,10]. Single cases of sand aspiration during drownings and near drownings have also been described [11,12].…”

“…Furthermore, sand may be deposited postmortem in the deep respiratory passages in immersion deaths, e.g., if the body has been rolled by the waves on a beach [13] Fortunately, many of the accidental aspirations, notably those of children being buried under sand masses, were survived after successful bronchoscopy treatment [5,7,8,11,14] or application of bronchodilators and postural drainage alone [2]. In a number of cases, sand aspiration was due to the deposition of sand masses on the head of homicide victims [1]. In conclusion, the fatalities due to sand aspiration reported so far were ascribed to extraneous causes.…”