Image Based Question – 65901

The hemorrhages seen in the picture below (marked by a white arrow) in an autopsy of lung signifies death by?

A. Hanging.

B. Drowning.

C. Strangulation.

D. None of the above.

Show Answer

Correct Answer » B Explanation

Ans:B. Drowning

The hemorrhages shown in the picture above represents Paltauf’s hemorrhages.

Causes of death in drowning:

• Vagal inhibition.

• Asphyxia from laryngeal spasm.

• Haemodilatation (Fresh water drowning)

• Haemoconcentration (Salt water drowning)

Circumstances of drowining:

• Accidental

• Suicidal

• Homicidal:

Hand & feet tied in a way which cannot be done by the person himself, placed in gunny bag.

Injuries are severe enough not be self inflicted & severe to cause death.

If ligature is found.

If heavy wt. is found attached to the body.

If body is found inside gunny bag.

• Surreptitious disposal: A person is killed at one place & dispose at other place to hide the crime & to mislead the investigation.

Autopsy Findings of death due to Drowning

• Presence of weeds, stone etc firmly grasped in the hand.

• Large amounts of froth present around nostrils and mouth in freshly drowned bodies. This froth is also present in the upper and lower airways.

• After water inhalation, the lungs may be over inflated, filling the thoracic cavity, generally water logged referred to as “emphysema aquosum”

• The alveolar walls may rupture due to increased pressure during forced expiration and produce hemorrhages which when present sub-pleurally are called Paltauf’s hemorrhages.

• Paltauf’s hemorrhages are shining, pale bluish red and usually present in lower lobes of lungs.

• The presence of water in the stomach and intestine.

• Findings of diatoms in the tissue:

Diatoms are aquatic unicellular algae

Diatom has an extracellular coat composed of silica.

Presence of diatoms in brain or bone is an indication of antemortem inhalation of water.

If a person drowns in water containing diatoms, the diatoms will reach the lungs and some of them will penetrate the alveolar wall.

Only a live body with a circulation could transport diatoms from the lungs to the brain, bone marrow, liver and other viscera and skeletal viscera.

• The skin becomes wrinkled, pale and sodden like a “washer woman’s skin”. These changes appear at the finger tips, palms, backs of the hands, and later, the soles.

• The next step is the detachment of the thick keratin of hands and feet which pull off in “glove and stoking fashion”. Nails and hair become loosened after a few days.

• Other signs of immersion are cutis anserine and post-mortem distribution of hypostasis.

• Gettler test “depends on the assumption that, in persons drowning in sea water, the ingestion of highly saline water will lead to an increased blood chloride concentration in the left heart as compared to the right and, in persons drowning in fresh water, a dilution of blood chlorides in the left heart as compared to the right.”