Diatomological investigation in sphenoid sinus fluid and lung tissue from cases of suspected drowning

Lin, Chun-Yen; Yen, Wen-Chien; Hsieh, Hsing-Mei; Tsai, Li-Chin; Huang, Tsun-Ying; Huang, Chao-Ching; Yu, Yu-Jen; Shun, Chia‐Tung; Wu, Jiunn‐Tzong; Chou, Chuan-Ling; Linacre, Adrian; Lee, James Chun-I

doi:10.1016/j.forsciint.2014.08.023

Cited by 22 publications

(8 citation statements)

References 12 publications

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“…Upon brain removal, the petrous ridges may appear dark-red as a result of subcortical congestion with hemorrhage, purportedly as a result of pressure changes in middle ear pressure incurred by a sinking body (72) ( Image 13 ). Five to 10 milliliters of red-tinged watery fluid sometimes admixed with aquatic debris can at times be aspirated from the sphenoid sinus and has been used in quantitative analysis of diatoms to support the diagnosis of drowning (73), though again, this is not commonly performed as water could also enter this area after death ( Image 14 ). The finding of hemolytic intimal staining of the aorta in freshwater drownings is described and an added supportive finding knowing that this finding is also seen in other types of deaths and is a common finding in decomposed bodies (74).…”

Section: Discussionmentioning

confidence: 99%

“…Contamination leading to false positives for the presence of diatoms that could lead to a misdiagnosis also remains one of the issues of concern cited by researchers (70). With the development of more streamlined extraction methods with shorter turnaround-times and overall higher sensitivity and specificity, the successful recovery of diatoms from a variety of tissues and fluids (lung, liver, kidney, bone marrow, and cavity fluid) along with comparison to that found in the drowning medium has been shown to be an occasionally useful adjunct to not only the diagnosis of drowning but also in the ruling out of drowning as the cause of death (70, 71, 103, 104). That being said, due to the various difficulties discussed, diatom examination is not considered standard of practice when investigating potential water-related deaths.…”

Section: Discussionmentioning

confidence: 99%

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Investigation of Drowning Deaths: A Practical Review

Armstrong

Erskine

2018

Academic Forensic Pathology

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Drowning, which typically involves a watery environment, remains a serious public health concern claiming an estimated 362 000 lives per year worldwide across all socioeconomic classifications and has remained under close observation by the World Health Organization and its signatories. A significant number of water-related deaths are attributed to accidental drowning, while a smaller but still significant number represent suicidal or homicidal drowning. Others involve a combination of drowning precipitated by injury, intoxication, or environmental extremes. Still others involve victims that die from injury, intoxication, or a natural disease entity of such significance as to preclude the drowning process, while near or in water. While there may be an initial presumption that all water-related deaths are accidental drownings, other possibilities must be considered in the investigation of these types of deaths, as drowning as a cause of death is a diagnosis based on the exclusion of other potential causes. The coordinated investigative efforts of multiple agencies and disciplines are required not only for the designation as drowning as the cause of death but also for death certification. The ongoing analysis and dissemination of data generated from all levels of investigation augment our understanding of the impact on public health and safety, guiding allocation of monetary and educational resources in an effort to prevent further mortality and disability.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Investigation of Drowning Deaths: A Practical Review

Armstrong

Erskine

2018

Academic Forensic Pathology

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“…Perhaps no other ancillary test in the diagnosis of drowning in humans has received as much attention, scrutiny, and debate as the use of diatoms. 14,20,34,42,46,47,65,67 –70,77,90 Diatoms are unicellular algae with a silica cell wall (frustrule) that makes them inert to acids, high temperatures and enzymatic digestion. 91 The use of diatoms as a diagnostic test for drowning is based on the assumption that the individual must be alive for them to be aspirated, penetrate the alveolar-capillary membrane, enter the circulation, and enter tissues including marrow.…”

Section: Ancillary Tests Used In Determination Of Drowningmentioning

confidence: 99%

Veterinary Forensic Pathology

McEwen

Gerdin²

2016

Vet Pathol

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Determining the cause of death in animals recovered from bodies of water, swimming pools, or other water-containing vessels is challenging. Animals recovered from water may or may not have drowned. The diagnosis of drowning is usually one of exclusion, requiring information from the crime scene, recovery scene, the medical history or reliable witness accounts. While there are characteristic macroscopic and microscopic lesions of drowning, none are specific and are dependent on the volume and tonicity of the drowning medium. Beyond interpreting the postmortem findings, the court may ask pathologists to comment on the behavioral and welfare implications of drowning. This requires an understanding of the drowning process, which is a complex series of sequential, concurrent, and overlapping cardiorespiratory reflexes, electrolyte and blood gas abnormalities, aspiration, physical exhaustion, and breathlessness eventually culminating in death. This review addresses the mechanisms, lesions, and diagnostic issues associated with drowning in nonaquatic companion animals.

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“…not decomposed corpses may show several findings indicative of drowning; froth in the airways, watery fluid in the paranasal sinuses, diffuse red spots (Paltauf spots) on the pleura and a red discolouration of the great artery walls due to haemolysis, an acute emphysema or pulmonary oedema and watery fluid in the stomach and duodenum which may -ideally in combination with the detection of diatoms in peripheral lung tissue [4] and internal organs -allow for the diagnosis of a death due to drowning.…”

Section: Introductionmentioning

confidence: 99%