The diagnosis of drowning. A review

Lesions associated with drowning in bycaught penguins

“…The overall volume of the lungs was markedly increased, however the presence of liquid in the pulmonary airways did not seem to be accompanied by significant loss of structure or rupture of the parabronchial septa, in contrast to the emphysema aquosum that is classically described in humans (Püschel et al 1999, Salomez & Vincent 2004, Lunetta & Modell 2005. If inhaled into the lungs, the hyperosmotic nature of seawater is expected to lead to an intense outflow of intravascular fluids to the airways, resulting in haemoconcentration and severe pulmonary oedema (Timperman 1972, Modell 1993, Lunetta & Modell 2005. It was not possible to quantify the extent to which the fluid in the lungs corresponded to inhaled water, to passive extravasation of intravascular fluids due to osmotic forcing, to an increased vascular permeability due to an acute inflammatory response, to pulmonary oedema secondary to the increased hydrostatic pressure within blood vessels, or to a combination of 2 or more of these factors.…”

Drowning: Still a difficult autopsy diagnosis

“…Herewith, the risk of contamination matters a lot [21][22][23]. In addition, due to the pollution of the surface waters, diatoms could vanish in the future [24]. Indeed, an obvious impoverishment of the diatom species was observed and, e.g., in Belgian mere, only one species survives, namely Eunotia exigua [25].…”

“…Those deaths can in fact be natural deaths. Modell et al stated that ''to ascribe drowning as a cause of death to a body found in water without some evidence of the effect of having aspirated water is risky'' and concluded that ''in this situation, it may be more accurate to list a differential diagnosis rather www.elsevier.com/locate/forsciint Forensic Science International 163 (2006) [1][2][3][4][5][6][7][8][9] than a specific cause of death'' [2]. Police information such as eye-witnessing can, as an example, be much more reliable.…”

“…Drowning has extensively been discussed in medicolegal literature and historical reviews can be found by Reh [3], Thomas et al [4], Timperman [5], Keil [6], Saukko and Knight [7], Ludes and Fornes [8], Brinkmann [9] and Giertsen [10].…”

Algae in Forensic Investigations

“…The force of this inhalation causes aveolar-capillary membranes in the lungs to rupture, allowing the diatom frustules to enter the bloodstream. The still-beating heart of the drowning victim then transports the diatoms in the bloodstream to organs in the body (Timperman 1972;Pollanen et al 1997;Pollanen 1998;Keiper and Casamatta 2001;Aggrawal 2005). If the body had instead entered the water post mortem, water with diatoms may eventually have entered the lungs by sheer mechanical pressure alone, but those diatoms will not enter the bloodstream since the force of passive entry is too low for capillary rupture.…”