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Freshwater drowning - postmortem

Case contributed by Jakob Heimer
Diagnosis certain


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

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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