Skip to main content
SpringerLink
Log in

Postmortem Imaging in Drowning

  • Chapter
  • First Online:
Radiology in Forensic Medicine

  • 1071 Accesses

Abstract

The diagnosis of drowning is one of the most difficult in the field of forensic medicine since the autopsy findings are often not specific and the laboratory examinations are controversially appreciated by the scientific community. In a cadaver recovered from water, it is of utmost importance to differentiate antemortem and postmortem drowning. This chapter fully investigates biological/thanato-chemical, pathological and imaging findings which may guide the definitive diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Tsokos M (2005) Forensic pathology reviews, vol 3. Humana Press, Totowa. (Macroscopical, Microscopical, and Laboratory Findings in Drowning Victims. A Comprehensive Review. Philippe Lunetta, MD and Jerome H. Modell, MD, DSc (Hon) Forensic Pathology Reviews, Vol. 3 Edited by: M. Tsokos © Humana Press Inc., Totowa, NJ)

    Book  Google Scholar 

  2. Asl N, Taftachi F, Memarian A, Kordrostami R, Zavareh F, Mehrpisheh S (2016) A 37-year-old woman found dead in a Jacuzzi: a case report. Med Leg J 84(3):159–161

    Article  PubMed  Google Scholar 

  3. Murayama M, Takahashi Y, R S, Watanabe K, Takahashi K, Kubo R, Kuninaka H, Kominato Y (2015) Characterization of five cases of suspected bathtub suicide. Leg Med (Tokyo) 17(6):576–578

    Article  Google Scholar 

  4. Levy AD, Harcke HT, Getz JM, Mallak CT, Caruso JL, Pearse L, Frazier AA, Galvin JR (2007) Virtual autopsy: two- and three-dimensional multidetector CT findings in drowning with autopsy comparison. Radiology 243(3):862–868

    Article  PubMed  Google Scholar 

  5. Pearn J (1985) Pathophysiology of drowning. Med J Australia 142:586–588

    CAS  PubMed  Google Scholar 

  6. Swann HG, Brucer M, Moore C, Vezien BL (1947) Fresh water and sea water drowning: a study of the terminal cardiac and biochemical events. Tex Rep Biol Med 5:423–437

    CAS  PubMed  Google Scholar 

  7. Swann HG, Brucer M (1949) The cardiorespiratory and biochemical events during rapid anoxic death. VI. Fresh water and sea water drowning. Tex Rep Biol Med 7:604–618

    CAS  PubMed  Google Scholar 

  8. Lawler W (1992) J Clin Pathol 45:654–659

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Prahlow JA, Byard RW (2012) Atlas of forensic pathology: for police. Forensic Scientists, Attorneys, and Death Investigators

    Google Scholar 

  10. Aggrawal A (2016) APC forensic medicine and toxicology for MBBS. Avichal, New Delhi. ISBN: 978-81-7739-491-7

    Google Scholar 

  11. Zhao J, Ma Y, Liu C, Wen J, Hu S, Shi H, Zhu L (2016) A quantitative comparison analysis of diatoms in the lung tissues and the drowning medium as an indicator of drowning. J Forensic Legal Med 42:75–78

    Article  CAS  Google Scholar 

  12. Rácz E, Könczöl F, Tóth D, Patonai Z, Porpáczy Z, Kozma Z, Poór VS, Sipos K (2016) PCR-based identification of drowning: four case reports. Int J Legal Med 130(5):1303–1307

    Article  PubMed  Google Scholar 

  13. Sheaff MY, Hopster DJ (2005) Post mortem technique handbook, 2nd edn. Springer, London

    Google Scholar 

  14. Du Chesne A, Cecchi Mureani R, Puschel K, Brinkmann B (1996) Macrophage subtype patterns in protracted asphyxiation. Int J Legal Med 109:163e6

    Google Scholar 

  15. Vacchiano G, D’Armiento F, Torino R (2001) Is the appearance of macrophages in pulmonary tissue related to time of asphyxia? Forensic Sci Int 115:9–14

    Article  CAS  PubMed  Google Scholar 

  16. Strunk T, Homaker D, Schulz R, Brinkmann B (2010) Reaction patterns of pulmonary macrophages in protracted asphyxiation. Int J Legal Med 124:559e68

    Article  Google Scholar 

  17. Dettmeyer RB (2011) Forensic histopathology: fundamentals and perspectives. Springer, Berlin

    Book  Google Scholar 

  18. Byard RW (2016) Adipocere-the fat of graveyards. Am J Forensic Med Pathol 37(3):208–210

    Article  PubMed  Google Scholar 

  19. Gotouda H, Takatori T, Terazawa K, Nagao M, Tarao H (1988) The mechanism of experimental adipocere formation: hydration and dehydrogenation in microbial synthesis of hydroxy and oxo fatty acids. Forensic Sci Int 37:249–257

    Article  CAS  PubMed  Google Scholar 

  20. Sorg MH, Dearborn JH, Monahan EI, Ryan HF, Sweeney KG, David E (1997) Forensic taphonomy in a marine context. In: Haglund WD, Sorg MH (eds) Forensic taphonomy. The postmortem fate of human remains. CRC Press, Boca Raton, FL, pp 567–604

    Google Scholar 

  21. Haglund WD, Sorg MH (2002) Human remains in aquatic environment. In: Haglund WD, Sorg MH (eds) Advances in forensic taphonomy. Method, theory, and archeological perspectives. CRC Press, Boca Raton, pp 201–218

    Google Scholar 

  22. Takatori T (2001) The mechanism of human adipocere formation. Legal Med (Tokyo) 3:193–204

    Article  CAS  Google Scholar 

  23. Vij K. Textbook of forensic medicine & toxicology: principles & practice, 5th Ebook. ISBN: 9788131236239. Imprint: Elsevier India

    Google Scholar 

  24. Omar HR, Mirsaeidi M, Bosco G, Morgan K, Dalvi P, Helal E, Mangar D, Camporesi EM (2017) Cardiovascular complications and mortality determinants in near drowning victims: a 5-year retrospective analysis. J Crit Care 37:237–239

    Article  PubMed  Google Scholar 

  25. Kakizaki E, Kozawa S, Imamura N, Uchiyama T, Nishida S, Sakai M, Yukawa N (2011) Detection of marine and freshwater bacterioplankton in immersed victims: post-mortem bacterial invasion does not readily occur. Forensic Sci Int 211(1–3):9–18

    Article  PubMed  Google Scholar 

  26. Rutty GN, Johnson C, Amoroso J, Robinson C, Bradley CJ, Morgan B (2017) Post-mortem computed tomography coaxial cutting needle biopsy to facilitate the detection of bacterioplankton using PCR probes as a diagnostic indicator for drowning. Int J Legal Med 131(1):211–216

    Article  PubMed  Google Scholar 

  27. Nucci MP, Lukasova K, Sato JR, Amaro E (2017) Brain injury after moderate drowning: subtle alterations detected by functional magnetic resonance imaging. Brain Imaging Behav 11(5):1412–1421

    Article  PubMed  Google Scholar 

  28. Iino M, Aoki Y (2016) The use of radiology in the Japanese tsunami DVI process. JFRI 4:20–26

    Google Scholar 

  29. Lo Re G, Vernuccio F, Galfano MC, Picone D, Milone L, La Tona G, Argo A, Zerbo S, Salerno S, Procaccianti P, Midiri M, Lagalla R (2015) Role of virtopsy in the post-mortem diagnosis of drowning. Radiol Med 120:304–308

    Article  PubMed  Google Scholar 

  30. Kawasumi Y, Kawabata T, Sugai Y, Usui A, Hosokai Y, Sato M, Saito H, Ishibashi T, Hayashizaki Y, Funayama M (2012) Assessment of the relationship between drowning and fluid accumulation in the paranasal sinuses on post-mortem computed tomography. Eur J Radiol 81(12):3953–3955

    Article  PubMed  Google Scholar 

  31. Biljardta S, Brummela A, Tijhuisa R, Sieswerda-Hoogendoornb T, Beenenb LF, van Rijnb RR (2015) Post-mortem fluid stasis in the sinus, trachea and mainstem bronchi; a computed tomography study in adults and children. J Forensic Radiol Imaging 3:162–166

    Article  Google Scholar 

  32. Kawasumi Y, Kawabata T, Sugai Y, Usui A, Hosokai Y, Sato M, Saito H, Ishibashi T, Hayashizaki Y, Funayama M (2013) Diagnosis of drowning using post-mortem computed tomography based on the volume and density of fluid accumulation in the maxillary and sphenoid sinuses. Eur J Radiol 82(10):e562–e566

    Article  PubMed  Google Scholar 

  33. Kawasumi Y, Usui A, Sato Y, Sato Y, Daigaku N, Hosokai Y, Hayashizaki Y, Funayama M, Ishibashi T (2016) Distinction between saltwater drowning and freshwater drowning by assessment of sinus fluid on post-mortem computed tomography. Eur Radiol 26(4):1186–1190

    Article  PubMed  Google Scholar 

  34. Lundermose SB, Jacobsen C, Jakobsen LS, Lynnerup N (2015) Exact volumetric determination of fluid in the paranasal sinuses after drowning. J Forensic Radiol Imaging 3:111–116

    Article  Google Scholar 

  35. Bolliger S, Ross S, Marino L, Thali MJ, Schweitzer W (2015) Shell fragment aspiration seen at post-mortem computed tomography indicating drowning. J Forensic Radiol Imaging 3:87–90

    Article  Google Scholar 

  36. Arun Babu T, Ananthakrishnan S (2013) Unusual presentation of sand aspiration in a 14-mo-old child. Indian J Pediatr 80(9):786–788

    Article  PubMed  Google Scholar 

  37. Vander Plaetsen S, De Letter E, Piette M, Van Parys G, Casselman JW, Verstraete K (2015) Post-mortem evaluation of drowning with whole body CT. Forensic Sci Int 249:35–41

    Article  PubMed  Google Scholar 

  38. Christe A, Aghayev E, Jackowski C, Thali MJ, Vock P (2008) Drowning—post-mortem imaging findings by computed tomography. Eur Radiol 18(2):283–290

    Article  PubMed  Google Scholar 

  39. Hyodoh H, Terashima R, Rokukawa M, Shimizu J, Okazaki S, Mizuo K, Watanabe S (2016) Experimental drowning lung images on postmortem CT—difference between sea water and fresh water. Leg Med (Tokyo) 19:11–15

    Article  CAS  Google Scholar 

  40. Usui A, Kawasumi Y, Funayama M, Saito H (2014) Postmortem lung features in drowning cases on computed tomography. Jpn J Radiol 32(7):414–420

    Article  PubMed  Google Scholar 

  41. Shiotani S, Kobayashi T, Hayakawa H, Kikuchi K, Kohno M (2011) Postmortem pulmonary edema: a comparison between immediate and delayed postmortem computed tomography. Leg Med (Tokyo) 13(3):151–155

    Article  Google Scholar 

  42. Usumoto Y, Sameshima N, Hikiji W, Tsuji A, Kudo K, Inoue H, Ikeda N (2009) Electrolyte analysis of pleural effusion as an indicator of drowning in seawater and freshwater. J Forensic Legal Med 16(6):321–324

    Article  Google Scholar 

  43. Yajima D, Saito H, Sato K, Hayakawa M, Iwase H (2013) Diagnosis of drowning by summation of sodium, potassium and chloride ion levels in pleural effusion: differentiating between freshwater and seawater drowning and application to bathtub deaths. Forensic Sci Int 233(1–3):167–173

    Article  CAS  PubMed  Google Scholar 

  44. Szeremeta M, Janica JR, Niemcunowicz-Janica A, Pepinski W (2013) Fatal drowning as a result of an airplane crash—case report. Forensic Sci Int 226(1–3):e12–e15

    Article  PubMed  Google Scholar 

  45. Idris AH, Berg RA, Bierens J, Bossaert L, Branche CM, Gabrielli A, Graves SA, Handley AJ, Hoelle R, Morley PT, Papa L, Pepe PE, Quan L, Szpilman D, Wigginton JG, Modell JH (2003) American Heart Association. Recommended guidelines for uniform reporting of data from drowning: the “Utstein style”. Circulation 108(20):2565–2574

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Biomedicina, Neuroscienze, Diagnostica Avanzata (BIND), University of Palermo, Palermo, Italy

    Federica Vernuccio, Giuseppe Lo Re & Massimo Midiri

  2. Department of Sciences for the Promotion of Health and Maternal and Child Care “G. D’Alessandro”, University of Palermo, Palermo, Italy

    Stefania Zerbo, Donatella Piscionieri, Federico Midiri & Antonina Argo

  3. Dipartimento di Biomedicina, Neuroscienze, Diagnostica Avanzata (BIND), University of Palermo, Palermo, Italy

    Federico Midiri

Authors
  1. Federica Vernuccio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stefania Zerbo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Donatella Piscionieri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Federico Midiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Giuseppe Lo Re
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Massimo Midiri
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Antonina Argo
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Policlinico Paolo Giaccone Radiology Department, Palermo, Italy

    Giuseppe Lo Re

  2. Department of Health Promotion, Maternal and Child Care, Policlinico Giaccone, Palermo, Italy

    Antonina Argo

  3. Institute of Radiology University Hospital, Palermo, Italy

    Massimo Midiri

  4. Department of Biomedical Sciences, University of Milan, Milan, Italy

    Cristina Cattaneo

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Vernuccio, F. et al. (2020). Postmortem Imaging in Drowning. In: Lo Re, G., Argo, A., Midiri, M., Cattaneo, C. (eds) Radiology in Forensic Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-96737-0_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-96737-0_23

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-96736-3

  • Online ISBN: 978-3-319-96737-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation