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FORENSIC PATHOLOGY

FORENSIC PATHOLOGY. DEATH BY DROWNING (Dr. Asif Idrees). DEATH BY DROWNING. Caused by submersion in a liquid Death due to asphyxia with water occluding the airways. Drowning. physiological responses: Cardiac changes- leading to asphyxia

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FORENSIC PATHOLOGY

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  1. FORENSIC PATHOLOGY DEATH BY DROWNING (Dr. Asif Idrees)

  2. DEATH BY DROWNING • Caused by submersion in a liquid • Death due to asphyxia with water occluding the airways

  3. Drowning • physiological responses: • Cardiac changes- leading to asphyxia • Period of panic or hyperventilation- animal try to hold breath – co2 conc. In blood stream forces to take involuntary breath.- Aspiration of water into the lungs, stomach. • Fresh water dilutes surfactants - Causes alveolar collapse • Salt water - Hypertonic- draws water from interstitial spaces into the alveoli - alveolar filling (secondary drowning) • Amount of water more significant than type of water • Loss of consciousness within 3 minutes - Cerebral hypoxia, death within 10 minutes

  4. DEATH BY DROWNING • Dry Drowning • Laryngeal spasm through vagal reflex. • Lungs have no edema • May form a plug of mucous and froth • Death due to cerebral hypoxia • Hypothetical, great variation of theories

  5. Attempted drowning or inflicted submersion injury. • injuries seen usually are caused by hypoxemia and the aspiration of the water. • Less volume of water found • Amount of damage depends upon extent of pulmonary collapse, Type of water (fresh or salted), presence of debris, sand or chemicals • Animal vomit may be conclusive • Development of secondary pneumonia due to bacterial spp. • Hypoxemia injuries can include cerebral edema, and death

  6. DROWNING • Physiology of Drowning • Hold breath • Build up of Carbon Dioxide • PCO2 = 55 mmHg • Involuntary inhalation • Water in lungs and/or stomach • Cerebral Hypoxia • 3 – 60 min. • Depends on water temperature • Warm water 3-10 min • Cold Water up to 66 min

  7. Effect of Submersion on Deceased Victims • Wrinkled skin especially around foot pads- depends upon the time of water submersion. • The onset of rigor is variable, caused by ante mortem struggling, which can deplete ATP and water temperature. • Lividity may be pink in cold water drowning. • Decomposition depends upon temperature, salinity, pH, and bacterial content of the water. • Formation of adipocere- grayish-white to brown, firm, wax-like material found primarily in the s/c tissue. – Hinders decomposition

  8. Gross Examination Findings • No pathognomic findings. • white or hemorrhagic edema fluid in the nostrils, mouth, and airways (wet drowning) • Foam may be found coming out of the nose or mouth and may be found in the trachea and deeper airways. • may be white, off-white, or blood tinged and is caused by admixing of moving air with water. (specific sign of death inside water). • Absence of foam doesn’t rule out drowning evidence, may suggest interval between necropsy & death.

  9. lungs are large and bulky, and may bulge from the open thoracic cavity caused by the presence of water and entrapped air. • heavy because of pulmonary edema and the aspirated liquid within the lungs • On cut-section- brick-red in appearance and large quantities of edema fluid flow out. • Sampling:Samples of all water and debris found should be taken for testing. • Diatom test: The finding of diatoms in the tissues

  10. Post-mortem tissue consumption caused by small marine animals such as fish and crabs on the dorsal hand. The edges of the defect are typically scalloped.

  11. Large marine life such as sharks and alligators may consume large amounts of tissue and leave sharp injuries in the soft tissue and/or bone. In this case it may be difficult to determine whether the injuries represent ante-mortem trauma or post-mortem artifacts.

  12. DROWNING • Water Temperature • Cold Water • “Goose Pimples” • Body’s metabolism slows • No need for oxygen to produce ATP

  13. DROWNING • Autopsy Findings • Circumstances of Death • May be Suicide, Homicide, Accidental • Autopsy Inconclusive • Washerwoman hands • 20 – 30 min. • White or hemorrhagic edema fluids • Pulmonary edema is non-specific

  14. DROWNING • Tests for Drowning • Gettler Chloride Test • Levels less on right side of heart = drowned by saltwater • Levels less on left side of heart = drowned by freshwater • TEST DOES NOT WORK!!!

  15. DROWNING • Diatom tests • Microscopic unicellular algae • 5 to 500 μm in size • Silica skeleton • Inconclusive test • May be inhaled • May be ingested • May be aspirated in water

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