Drowning (postmortem findings)

Drowning is one of the most prevalent modalities of non-natural death. According to the WHO, an estimated 360,000 annual deaths occur due to drowning.

This article concerns itself with postmortem appearances in fatalities from drowning.For non-fatal pulmonary changes please refer to near-drowning pulmonary oedema

Drowning describes the process of submersion of at least the face in a liquid medium, followed by respiratory impairment and aspiration of fluids into the respiratory tract. Drowning is, therefore, a form of asphyxia. While aspiration of fluid into the lungs, known as "wet drowning", is most common, "dry drowning" without fluid aspiration occurs in about 10-15% of cases.

Drowning presents with a number of typical but not highly specific findings 2:

  • frothy foam in the nasal cavity and pharynx
  • fluid in the paranasal sinuses
    • found most often in the maxillary and ethmoidal sinuses followed by the sphenoidal and frontal sinuses 3
    • density measurements can differentiate saltwater and freshwater contents: saltwater has a higher density (mean 47 HU) than freshwater (32 HU) 5
  • fluid in the mastoid cells
  • fluid in the trachea and main bronchi
  • ground glass opacity (GGO) in the lungs forming a mosaic pattern, which may be differentiated as 1
    • reticular GGO with interstitial thickening
    • patchy GGO along the airways
  • (bilateral) pleural effusions 3,4
  • fluid distension and increased volume of the stomach and small intestine
    • the volume of the stomach has a water like density and is often layered in solid, liquid, and foam; see Wydler's sign (forensic)
  • increased total lung volume and decreased radiodensity (HU) and lung density (g/l) 6
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Article information

rID: 54262
Systems: Forensic, Chest
Section: Signs
Tag: cases
Synonyms or Alternate Spellings:

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