Haemolytic staining of the intima of the aortic root – A useful pathological marker of freshwater drowning?

The significance of haemolytic staining of the aorta is unclear. While it has been associated with freshwater drowning, data are lacking. To study this phenomenon further a prospective study looking at the colour of the intima of the pulmonary trunk and aortic root was undertaken in 47 randomly selected coronial control cases and in 13 consecutive fresh drowning deaths. There were 16 putrefied control cases each of which showed haemolytic staining of both great vessels. Of the other 44 non-putrefied cases (31 controls, 9 saltwater drownings, and 4 freshwater drownings), only one (a freshwater drowning) showed marked staining of the aortic root with no staining of the intima of the pulmonary trunk. Conclusion: This study has demonstrated that haemolytic staining of the aorta at autopsy, in the absence of significant staining of the pulmonary trunk and putrefaction, may be a pathological feature that is supportive of freshwater drowning. It is not, however, present in all cases. Given the relatively small numbers in this study further work is required to clarify this issue.