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da Trindade RQ, Duarte Morais Vieira MG, Vieira RB, Vicentin-Junior CA, Damascena NP, Santiago BM, Martins-Filho PR, Palhares Machado CE. The role of paranasal sinus fluid in determining drowning as the cause of death: A systematic review and meta-analysis. J Forensic Leg Med 2023; 99:102591. [PMID: 37717366 DOI: 10.1016/j.jflm.2023.102591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/21/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023]
Abstract
Drowning is a significant global cause of unintentional injury fatalities, and accurate forensic diagnosis of drowning remains a challenge due to the nonspecific nature of post-mortem findings obtained through classical autopsy methods. Our manuscript addresses this issue by focusing on the emerging use of paranasal sinus fluid as a valuable tool in determining the cause of death, specifically in distinguishing drowning from non-drowning cases. The study provided a comprehensive summary of available evidence from observational studies that compared findings in the paranasal sinuses between drowning and non-drowning victims, analyzing parameters such as the presence of fluid, fluid volume, and density. The study encompassed a total of 14 selected studies involving 1044 subjects and utilized rigorous risk of bias assessment and data synthesis techniques. The meta-analysis demonstrated a strong association between the presence of fluid in the paranasal sinuses and drowning (OR = 17.1; 95% CI 7.2 to 40.5; p < 0.001). In addition, drowning victims had a significantly greater volume of fluid (SMD = 0.8; 95% CI 0.5 to 1.2; p < 0.001) and lower fluid density (SMD = -1.4; 95% -2.5 to -0.4; p = 0.008) compared to non-drowning cases. The results support the utility of paranasal sinus fluid analysis as a valuable diagnostic method in cases where drowning is suspected but cannot be definitively confirmed through traditional approaches.
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Affiliation(s)
- Rafael Queiroz da Trindade
- Graduate Program in Oral Biology, Piracicaba Dental School, State University of Campinas, UNICAMP, São Paulo, Brazil
| | | | - Raíssa Bastos Vieira
- Graduate Program in Pathology, Ribeirão Preto Medical School, University of São Paulo, USP, São Paulo, Brazil
| | | | | | | | - Paulo Ricardo Martins-Filho
- Graduate Program in Health Sciences, Federal University of Sergipe, Sergipe, Brazil; Investigative Pathology Laboratory, Federal University of Sergipe, Sergipe, Brazil.
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Heo JH, Yoon Y, Seo IS, Im SB, Ko YS, Lee S, Jang SJ. The significance of evaluating sphenoid sinus fluid by postmortem computed tomography in cases of drowning. J Forensic Leg Med 2023; 97:102551. [PMID: 37339573 DOI: 10.1016/j.jflm.2023.102551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 05/12/2023] [Accepted: 06/11/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE In cases of drowning, the presence of sphenoid sinus fluid is a non-specific autopsy finding. However, studies have reported that fluid accumulation in the paranasal sinuses is more commonly observed in drowning victims. Furthermore, some laboratory tests, such as diatom and electrolyte analysis, can serve as supplementary diagnostic tools for diagnosing drowning. Therefore, accurate sphenoid sinus fluid sampling is an important aspect of an autopsy in suspected drowning cases. The aim of this study was to identify the significance of evaluating sphenoid sinus fluid by PMCT images in cases of drowning. METHODS We retrospectively reviewed 54 drowning victims who underwent PMCT and forensic autopsy. Fluid volume in the sphenoid sinus was measured using a graduated syringe during autopsy and a three-dimensional (3D) workstation based on PMCT images was used for the purpose of comparison. The Mann-Whitney U test and Spearman's rank correlation coefficient was used to evaluate statistically significant differences and correlations. Additionally, a Bland-Altman plot was employed to assess the agreement between PMCT and autopsy. RESULTS The median volume was 1.65 (range 0.00-12.4) ml and 1.55 (range 0.00-7.00) ml in the PMCT and autopsy, respectively, showing a statistically insignificant difference (p = 0.294) and a significant correlation (Rs = 0.896). In 35 cases, the PMCT overestimated the fluid volume more than the autopsy, whereas in 14 cases, the PMCT underestimated the fluid volume. No fluid was identified in seven cases during the autopsy, whereas in five patients, no fluid was found in both PMCT and autopsy. By analyzing the Bland-Altman plot, a bias of 0.73 ± 1.4 ml and limits of agreement ranging from -2.04 to 3.51 ml were observed for sphenoid sinus fluid volume measurements. CONCLUSIONS Based on the limitations of traditional fluid volume measurement in the sphenoid sinus during autopsy, we propose the utilization of PMCT volumetric analysis prior to autopsy as a means to enhance the detection of sphenoid sinus fluid in cases of drowning.
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Affiliation(s)
- Jin-Haeng Heo
- Forensic Medicine Division, Busan Institute, National Forensic Service, Yangsan, Republic of Korea; Department of Multidisciplinary Radiological Science, The Graduate School of Dongseo University, Busan, Republic of Korea
| | - Yongsu Yoon
- Department of Multidisciplinary Radiological Science, The Graduate School of Dongseo University, Busan, Republic of Korea; Center for Radiological Environment & Health Science, Dongseo University, Busan, Republic of Korea.
| | - In-Soo Seo
- Forensic Medicine Division, Busan Institute, National Forensic Service, Yangsan, Republic of Korea
| | - Sang-Beom Im
- Forensic Medicine Division, Gwangju Institute, National Forensic Service, Jangseong, Republic of Korea
| | - Young San Ko
- Forensic Medicine Division, Busan Institute, National Forensic Service, Yangsan, Republic of Korea
| | - Sookyoung Lee
- Division of Forensic Medical Examination, National Forensic Service, Wonju, Republic of Korea
| | - Seon Jung Jang
- Forensic Medicine Division, Busan Institute, National Forensic Service, Yangsan, Republic of Korea
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Bhardwaj N, Ahluwalia AS, Pal SK, Mandotra SK. Potential of photoautotrophic microbial organisms in deciphering forensic issues. Leg Med (Tokyo) 2023; 62:102223. [PMID: 36857944 DOI: 10.1016/j.legalmed.2023.102223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/13/2023] [Accepted: 02/18/2023] [Indexed: 02/23/2023]
Abstract
In forensic pathology, solving the crime mystery of death due to drowning still remains a challenging issue. The amalgamation of autopsy findings and comparative study of diatoms recovered from the victim's body organs and suspected drowning site help to decipher the cause of death due to drowning or post-mortem immersion. Since the correct interpretation of the cause of death is an important criterion to provide justice to the victim, therefore, the main objective of our study is to throw light on the application of photoautotrophic micro-algal organisms, known as Diatoms, in solving seven cases of victims whose bodies were recovered from various water bodies of Himachal Pradesh, India. The diatom test was conducted by using reverse aqua regia solution (15 ml HNO3: 5 ml HCl) on the bone marrow extracted from the organs and water samples respectively. The informative outcomes of the experimental analysis demonstrated that the diatom test acts as a beneficial adjunct to solve drowning-related crimes where the exact cause of death remains hidden even after performing an autopsy of the victims. The protocol followed by the authors can be used conveniently to recover diatoms from bone marrow as well as from water samples. Our results showed that the maximum cases were of death due to accidental drowning but for one case of suicidal drowning in extremely cold water.
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Affiliation(s)
- Nitika Bhardwaj
- Institute of Forensic Science and Criminology, Panjab University, Chandigarh, India.
| | - A S Ahluwalia
- Department of Botany, Eternal University, Baru Sahib, Himachal Pradesh, India.
| | - S K Pal
- Department of Biology and Serology, Directorate of Forensics Services, Shimla Hills, Junga Himachal Pradesh, India
| | - S K Mandotra
- Department of Botany, Panjab University, Chandigarh, India.
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Ikeda-Murakami K, Ikeda T, Tani N, Aoki Y, Ishikawa T. Sudden child death with acute encephalitis due to human herpesvirus 7: A case report and review of the literature. FORENSIC SCIENCE INTERNATIONAL: REPORTS 2022. [DOI: 10.1016/j.fsir.2021.100249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Tsuneya S, Nakajima M, Makino Y, Torimitsu S, Yamaguchi R, Iwase H. A quantitative comparison between using sodium hypochlorite as a digestion method for the diatom test and the conventional method using fuming nitric acid. Forensic Sci Int 2021; 329:111086. [PMID: 34749279 DOI: 10.1016/j.forsciint.2021.111086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/23/2021] [Accepted: 10/25/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the efficacy of using sodium hypochlorite (NaClO, Purelox) as a simple and rapid alternative digestion method for the diatom test through a quantitative comparison with the conventional method that uses fuming nitric acid (HNO3). MATERIALS AND METHODS In experiment 1, using 30 water samples, the NaClO and HNO3 methods were compared using paired t-test. In experiments 2 and 3, we included blank human lung plus 13 water samples and total of 32 drowned human lung samples, respectively, to compare the NaClO and HNO3 methods using paired t-test. The relationship between the concentration ratio and background factors was tested in experiment 3. Welch's t-test was used to determine differences in the ratio between the lung side and sex, whereas Pearson's correlation coefficient was used to determine the correlation between the ratio and either age or postmortem interval. The geometric mean of two counts was used for each specimen and all counts were logarithmically transformed to base 2 in the statistical analysis. RESULTS The NaClO method was completed within 80 min for any sample. In experiment 1, there was no significant difference between the NaClO and HNO3 methods using water samples (the mean of the ratios: 0.99, 95% confidence interval (95%CI: 0.89-1.10, P = 0.80). In experiment 2, the count of the NaClO method was lower than that of the HNO3 method using lung plus water samples (the mean of the ratios: 0.47, 95% CI: 0.35-0.65, P = 0.0002). In experiment 3, the concentration of the NaClO method was lower than that of the HNO3 method using drowned lung samples (the mean of the ratios: 0.28, 95% CI: 0.20-0.38, P < 0.0001). A weak correlation between the postmortem interval and the ratio of the two methods was observed (r = -0.58, P = 0.012), although no difference between lung sides or sexes were detected (P = 0.87 and P = 0.50, respectively) and no correlation occurred between age and the ratio (r = 0.15, P = 0.43). CONCLUSION Using NaClO as a simple and rapid digestion method for diatom testing of water samples would be an excellent alternative to conventional methods. Although the method's diatom detection rate for the lung samples was not optimal, it was still shown to be a feasible method.
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Affiliation(s)
- Shigeki Tsuneya
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Makoto Nakajima
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yohsuke Makino
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Suguru Torimitsu
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Rutsuko Yamaguchi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Hirotaro Iwase
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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Zhang L, Nie Q, Dai Y, Zhu S, Wang J, Wang W, Tan X, Zhang P, Li J. Diatomological mapping of water bodies in Chongqing section of the Yangtze River and Jialing River. Int J Legal Med 2020; 134:1375-1385. [PMID: 32342180 DOI: 10.1007/s00414-020-02297-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/03/2020] [Indexed: 10/24/2022]
Abstract
The diagnosis of drowning is one of the most difficult in forensic medicine. Forensic diatomology has been proposed to be useful in solving the diagnosis of drowning and considered to be a reliable indicator of the site of drowning. The Yangtze River and Jialing River are the main rivers in the Chongqing area (China), and a large number of corpses are found in the rivers every year. However, the distribution of diatoms in the rivers was not fully studied. In the presented study, a Microwave Digestion-Vacuum Filtration-Scanning Electron Microscopy (MD-VF-SEM) method was performed to acquire the qualitative and quantitative data of diatoms of water samples collected from 10 different sites of the Yangtze River and Jialing River in Chongqing section during different seasons. Our study not only created the diatomological maps of water bodies in Chongqing section of the Yangtze River and Jialing River for the first time but also identified some seasonal and site-specific diatoms that can be taken as markers of particular sites or seasons of drowning. The results of our study may provide forensic scientists helpful reference in solving the drowning cases.
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Affiliation(s)
- Li Zhang
- Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Yixueyuan Road 1#, Yuzhongqu, Chongqing, China
| | - Qianyun Nie
- Department of Forensic Medicine, Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Xueyuan Road 3#, Longhuaqu, Haikou, China.,Department of Medical Section, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Yalei Dai
- Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Yixueyuan Road 1#, Yuzhongqu, Chongqing, China
| | - Shisheng Zhu
- Faculty of Medical Technology, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Jinbao Wang
- Chongqing Municipal Public Security Bureau water branch material evidence identification Office, Chongqing, China
| | - Wei Wang
- Chongqing Municipal Public Security Bureau water branch material evidence identification Office, Chongqing, China
| | - Xiaobo Tan
- Chongqing Municipal Public Security Bureau water branch material evidence identification Office, Chongqing, China
| | - Peng Zhang
- Department of Forensic Medicine, Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Xueyuan Road 3#, Longhuaqu, Haikou, China. .,Key Laboratory of Emergency and Trauma of Ministry of Education, Hainan Medical University, Haikou, China.
| | - Jianbo Li
- Department of Forensic Medicine, Faculty of Basic Medical Sciences, Chongqing Medical University, Yixueyuan Road 1#, Yuzhongqu, Chongqing, China.
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The persistent problem of drowning - A difficult diagnosis with inconclusive tests. J Forensic Leg Med 2019; 66:79-85. [PMID: 31229802 DOI: 10.1016/j.jflm.2019.06.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 06/07/2019] [Accepted: 06/12/2019] [Indexed: 12/27/2022]
Abstract
Although the diagnosis of drowning may appear straightforward the reality is that it is sometimes one of the most difficult in forensic pathology. To begin with, there is no universal agreement on what constitutes drowning with some definitions using the term in the absence of a lethal outcome. Next are the significant problems that arise in finding immersed bodies and in assessing the death scene. Prolonged post mortem intervals are associated with artefactual modifications of the body from putrefaction and post mortem animal predation. Both of these may create and disguise injuries. The absence of pathognomonic pathological features at autopsy and the presence of potentially life threatening underlying organic illnesses complicate determination of both the cause and manner of death. There may even be no autopsy findings to indicate that immersion had occurred. Finally, the unreliability of laboratory tests with significant overlap with control cases where death had no association with immersion presents further problems. Thus lethal drowning remains a complex event that requires the use of a wide variety of information sources, not just data gleaned from the dissection table.
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Armstrong EJ, Erskine KL. Investigation of Drowning Deaths: A Practical Review. Acad Forensic Pathol 2018; 8:8-43. [PMID: 31240023 PMCID: PMC6474464 DOI: 10.23907/2018.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/01/2017] [Accepted: 01/18/2018] [Indexed: 12/20/2022]
Abstract
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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Yajima D, Inokuchi G, Makino Y, Motomura A, Chiba F, Torimitsu S, Yamaguchi R, Hoshioka Y, Malakienė D, Raudys R, Iwase H. Diagnosis of drowning by summation of sodium, potassium, and chloride ion levels in sphenoidal sinus fluid: Differentiating between freshwater and seawater drowning and its application to brackish water and bathtub deaths. Forensic Sci Int 2018; 284:219-225. [PMID: 29427930 DOI: 10.1016/j.forsciint.2018.01.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 01/09/2018] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
Abstract
Analysis of ions in sphenoidal fluid can be a useful index for the diagnosis of drowning. We evaluated the reference ranges of non-drowning cases using statistical methods and three indices: sodium ion (Na+), summation of sodium and potassium ions (SUMNa+K), and summation of sodium, potassium and chloride ions (SUMNa+K+Cl). The reference ranges were 96≤Na+<152, 139≤SUMNa+K<179, 243≤SUMNa+K+Cl<311(mEq/L), respectively. Victim indices outside of the reference ranges indicate that the victim probably inspired water with higher or lower ion concentrations than those of body fluid in sphenoidal sinuses. Compared to the SUMNa+K+Cl index, the Na+ and SUMNa+K indices could distinguish among seawater drowning, freshwater drowning, and non-drowning. In drowning cases, sphenoidal fluid volume and time since death were not correlated, which suggests that water does not enter the sphenoidal sinuses after death and there is a different process for water accumulation in drowning and non-drowning cases. In bathtub cases, this method was not valid for the estimation of inspired water. Although it is necessary to observe the classical signs of drowning, this method is suitable for the estimation of drowning, especially in cases where pleural fluid or diatom tests are not available.
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Affiliation(s)
- Daisuke Yajima
- Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, 4-3 Kozunomori, Narita City, Chiba 286-8686, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Go Inokuchi
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yohsuke Makino
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Ayumi Motomura
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Fumiko Chiba
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Suguru Torimitsu
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Rutsuko Yamaguchi
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Yumi Hoshioka
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
| | - Dalė Malakienė
- State Forensic Medicine Service, Didlaukio St. 86E, LT-08303 Vilnius, Lithuania
| | - Romas Raudys
- State Forensic Medicine Service, Didlaukio St. 86E, LT-08303 Vilnius, Lithuania
| | - Hirotaro Iwase
- Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan
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Abstract
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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Affiliation(s)
- B. J. McEwen
- Animal Health Laboratory, Laboratory Services Division, University of Guelph, Guelph, Ontario, Canada
| | - J. Gerdin
- Antech Diagnostics, Hunt Valley, MD, USA
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