Diagnosis of drowning using post-mortem computed tomography – state of the art

Raux, C; Saval, Frédéric; Rougé, Daniel; Telmon, Norbert

doi:10.5114/amsik.2014.47744

Cited by 10 publications

(6 citation statements)

References 16 publications

(109 reference statements)

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“…Skeletal chest findings and, particularly, rib fracture location and characteristics concurred (together with circumstantial data) to explain the traumatic mechanism (i.e., crushing trauma); several authors reported the strong agreement between PMCT and autopsy in the evaluation of rib fractures [ 17 , 18 ]. Clear findings were also observed on the spine, confirming the usefulness of imaging to detect both fractures and dislocation [ 16 , 19 ]. Other interesting data were found in the airway examination, in which the post-mortem imaging highlighted the presence of foreign material with different densities in both upper and lower tracts.…”

Section: Discussionmentioning

confidence: 74%

The role of PMCT for the assessment of the cause of death in natural disaster (landslide and flood): a Sicilian experience

et al. 2021

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In this report, the authors provide a contribution of PMCT in assessing the cause of death due to natural disasters. Here, the PMCT findings of 43 subjects who died during both landslide and flood were described. The post-mortem imaging revealed, clearly, traumatic injuries and/or the presence of foreign material in airways allowing to assess the cause of death of each subject, together with external inspection and the collected circumstantial data. Particularly, the PMCT has been helpful for characterization and localization of the clogging substance in airways providing findings on bronchial branches involvement. Moreover, the investigation offered detailed data on skeletal injuries in all anatomic districts and put in evidence both the precise fracturing site and the characteristics of fracture stubs for each bone fracture. This report supports the recommendation of the virtual autopsy in a case with several victims, as in natural disasters, and its role as an alternative diagnostic investigation when the standard autopsy is not feasible.

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Section: Discussionmentioning

confidence: 74%

The role of PMCT for the assessment of the cause of death in natural disaster (landslide and flood): a Sicilian experience

et al. 2021

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“…Las imágenes por RM de este sistema aportan datos para el hallazgo de patologías de tipo traumático (laceraciones, fisuras y roturas de órganos huecos), ocasionadas, ya sea por heridas por arma de fuego, heridas por arma cortopunzante o traumas contundentes (caídas de gran altura y golpes) (53,54), así como de tipo accidental como el ahogamiento (Figura 5); en donde, haciendo uso de los potenciadores, se muestra la abundante cantidad de líquido con partes solidas en estómago y duodeno (Figura 5b) para luego realizar la autopsia (Figura 5a) donde se ve pinzamiento de la primera porción del duodeno (flechas).…”

Section: Ahogamientounclassified

Uso de la resonancia magnética y la tomografía computarizada en diagnóstico postmortem

Najar-Céspedes¹,

Fuentes-Martínez²

2017

MedUNAB

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Introducción: Ante la naturaleza heterogénea, complejidad inherente de la actividad de peritaje en medicina legal, el perito (profesional de la medicina o áreas afines) debe hacer el mejor uso de las herramientas técnicas y tecnológicas de las cuales disponga. La imagenología, referente al conjunto de las técnicas que permiten obtener imágenes del cuerpo humano con fines clínicos o científicos, en cualquiera de sus técnicas, reviste una potente herramienta de apoyo estableciendo hechos o pruebas técnicas en el campo legal. Objetivo: Analizar el uso de la resonancia magnética y la tomografía computarizada en el diagnóstico postmortem. Metodología: Se realizó búsqueda de información en las bases de datos PubMed, Science Direct, Springer Journal y en el motor de búsqueda Google Académico, usando los términos “Tomografía Computarizada por Rayos X”, “Espectroscopía de Resonancia Magnética”, “Autopsia” y “Medicina Legal” publicados en el periodo 2008-2015. Resultados: La resonancia magnética es útil para el estudio detallado de tejidos blandos y órganos, mientras que la tomografía computarizada permite la identificación de fracturas, calcificaciones, implantes y traumas. Conclusiones: En los reportes hallados en la búsqueda bibliográfica, en cuanto al uso de la resonancia magnética nuclear y la tomografía computarizada en casos postmortem, nombrados por la génesis del trauma, se halló correlación entre la utilización de la imagen y el correcto diagnóstico pericial en la autopsia. [Najar-Céspedes AP, Fuentes-Martínez EDJ. Uso de la resonancia magnética y la tomografía computarizada en diagnóstico postmortem. MedUNAB 2017; 20(2): 190-200].

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“…However, since the sinuses were aspirated blindly during autopsy, it is difficult to draw meaningful conclusions. The advent of powerful imaging technology, such as computer tomography (CT), has enabled a more robust and accurate approach to investigate fluid-filled paranasal sinuses [ 31 ], with several studies demonstrating that between 90 and 100% of suspected drowning victims exhibit the finding [ 5 , 32 – 36 ]. On the other hand, so do a significant proportion of non-drowned victims, where the cause of death ranges from mechanical asphyxiation (hanging) to burn and fire deaths [ 32 , 34 , 35 , 37 ].…”

Section: Introductionmentioning

confidence: 99%

Postmortem CT analysis of paranasal sinuses using an experimental model of drowning

Tyr,

Zilg,

Gelius

et al. 2024

Int J Legal Med

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Fluid-filled paranasal sinuses are suggested to be a valuable tool to distinguish between drowning and non-drowning postmortem, yet the mechanisms governing fluid entry remains unknown. We investigate if fluid-filled paranasal sinuses are caused by a passive influx from submersion or an active aspiration mechanism during drowning. The ovine nasal cavity and maxillary sinuses are remarkably similar anatomically to humans, and have been used for endoscopic surgical training in recent decades. We submerged 15 decapitated ovine heads from agricultural waste at a depth of 2 m in flowing water for 1, 8, and 24 h and 7 days. Paranasal sinuses were CT imaged and compared pre- and post-submersion to non-submerged controls. Furthermore, we examined the paranasal sinuses of a single homicide case of a non-drowned submerged subject. Results demonstrate that fluid passively enters the maxillary sinus postmortem in the non-drowned ovine heads following 1 h of submersion. Fluid volume was independent of submersion time and influenced by time out of water as well as handling, since volume was reduced between consecutive CT scans. In contrast to our hypothesis, the filling of the paranasal sinuses is due to passive influx of fluid from submersion rather than an active aspiration during drowning. The observation that paranasal sinuses were fluid-filled in a single medico-legal case of postmortem submersion supports the finding of passive influx. Consequently, careful interpretation of fluid-filled paranasal sinuses is required when bodies are found in water, as the finding cannot distinguish between postmortem submersion and drowning.

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Diagnosis of drowning using post-mortem computed tomography – state of the art

Cited by 10 publications

References 16 publications

The role of PMCT for the assessment of the cause of death in natural disaster (landslide and flood): a Sicilian experience

The role of PMCT for the assessment of the cause of death in natural disaster (landslide and flood): a Sicilian experience

Uso de la resonancia magnética y la tomografía computarizada en diagnóstico postmortem

Postmortem CT analysis of paranasal sinuses using an experimental model of drowning

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