Citation

Vinkel J, Bak P, Juel Thiis Knudsen P, Hyldegaard O. J. Forensic Sci. 2018; 63(1): 299-304.

Affiliation

Hyperbaric Medicine Centre, Department of Anesthesiology and Surgery, Head and Orthopedic Centre, University Hospital of Copenhagen, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.

Copyright

(Copyright © 2018, American Society for Testing and Materials, Publisher John Wiley and Sons)

DOI

10.1111/1556-4029.13526

PMID

28464277

Abstract

Immersion Pulmonary Edema (IPE) reduces the transport of gases over the respiratory membrane due to edema in the interstitium and respiratory zones. IPE has previously been described in both swimmers and divers, with a few known fatal cases. We have reviewed 42 SCUBA and snorkeling-related drowning deaths, and through a thorough analysis of each case, including both diving physiology and forensic pathology, we present IPE as a differential diagnosis to drowning in four cases. Our findings propose that; absence of watery content in the stomach and conducting airways, and liquid filled lungs without hyperexpansion, may be compatible with IPE. We suggest that IPE should be considered in cases where witness testimony reveals; no obvious signs of aspiration and rapid respiratory deterioration despite continuous breathing through an appropriate air source. The diagnosis should be based on the overall impression, including both the autopsy findings and the circumstances regarding the accident.

© 2017 American Academy of Forensic Sciences.

Language: en

Keywords

case study; death causes; diving; drowning; forensic pathology; forensic science; pulmonary edema