Freshwater drowning (postmortem)

Case contributed by Dr. Jakob Heimer

Presentation

Man was found dead in a local golf course water hazard in the morning after excessive alcohol consumption the evening before.

Patient Data

Age: 50 years
Gender: Male
CT

Postmortem CT

The nasal cavity is filled with frothy liquid. The paranasal sinuses show fluid levels.

The lungs show patchy consolidations, creating a mosaic formation typical for drowning cases.

Esophagus and trachea as well as the main bronchi are filled with liquid, indicating aspiration.

The stomach is filled with liquid. In this case, three layers of gastric contect (foam-liquid-sediment) can be differentiated.

Case Discussion

Having obtained evidence via postmortem radiology and autopsy, freshwater drowning was issued as cause of death.

The presented findings are typical for freshwater drowning. The combination of fluid levels in the paranasal sinuses, in the nasal cavity as well as in the trachea and main bronchi indicates drowning. Distension of the stomach and layered fluid levels are further typical findings. The patchy GGO is caused by differences in perfusion due to aspirations and/or consecutive bronchospasm. The layered gastric contents may be interpreted as the forensic Wydler's sign.

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Case information

rID: 54041
Case created: 20th Jun 2017
Last edited: 30th Jun 2017
System: Forensic
Inclusion in quiz mode: Excluded

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