Post-mortem evaluation of drowning with whole body CT

• New and up to now unpublished finding of pericardial fluid in drowning victims.
• Hemodilution in fresh water drownings is present in right atrium, IVC and spleen.
• A marker for emphysema aquosum can be visible by the lower position of the diaphragm.

PurposeThe aim of this study is to investigate the value of whole body computed tomography (WB-CT) in bodies recovered from water by analysis of the imaging findings after drowning.MethodsThe bodies of 41 drowning victims and 9 persons who died from mechanical asphyxia by hanging underwent post-mortem whole body computed tomography.Results and conclusionsExcessive fluid in the paranasal sinuses (98%), nasal pharynx (98%), oropharynx (95%), trachea (83%), ground glass opacities in the lung (89%), pleural fluid (71%), pericardial fluid (59%), esophageal fluid (81%), stomach fluid and distension (71%), duodenal (34%) and jejunal distension (31%) were the most frequent drowning related imaging findings which significantly differed from the group of mechanical asphyxia by hanging. In cases of fresh water drowning hemodilution was present in 79%. New and up to now unpublished findings were lower density in the spleen, indicative for hemodilution and detection of a pronounced amount of pericardial fluid, only seen in drowning victims.