Drowning-Autopsy findings

Externally

Postmortem lividity

• Seen over the face, head and neck and front of chest as the body floats in an upside down position
• Usually bright pink in color due to imbibition of oxygen through the water.
• But if the body floats in the water in upside down position for a quite longer duration
• Then the color usually becomes dusky and cyanotic.
• In turbulent water post mortem lividity may not develop at all.

Cutis anserina or goose fleshings

• Occurs due to contraction of the erector pillae muscles.
• It appears as a puckered appearance of the skin with hair standing.

Rigor mortis

•  Sets in early and passes of early due to exhaustion of the muscles.

• The eyes are half opened with dilated pupil
• Conjunctivae may be congested with sub conjunctival ecchymosis present.
• Hands show cadaveric spasm with grasping of weed, straw, hay etc. 

SKIN 

• Skin is pale, cold and clammy due to contraction of the superficial blood vessels with low body temperature
• Washer woman’s hands and feet are seen after 48 to 72 hours
• Where the skin of the palms and soles becomes beached, wrinkled and saddened.

• The epidermis separates from the dermis in glove and stocking fashion from the hands and feet.
• Weeds, grass, plants, mud or stones in tightly clenched hand
• Due to cadaveric spasm 
• Strongly suggest that the person was alive when drowned, as it indicates the struggle of person for life
• Abraded tips of fingers and toes, and sand under damaged nails have same significance.

Froth:

• Fine, white, copious, tenacious, lathery and persistent frothy foam in the shape of a balloon
• Seen oozing out from the mouth and nostrils and comes again after being wiped off.
• This is formed by the water inhaled into the lungs which causes irritation of the mucosa, leading to secretion of the mucus.
• This froth is pathognomonic of drowning, best indicator of antemortem drowning.
• When pressure is exuded upon the chest, then copious froth exudes.

Internal appearance

Airway

• Contain stiff foam or frothy fluid or gritty gravel or mud from the dirty water.
• Confirmed by performing a slide test.
• The contents of the airways are smeared over a glass slide and then another glass slide is drawn over it.
•  Presence of gritty sensation confirms drowning.

• Paltauf’s hemorrhage.
  • The lungs show large sub pleural hemorrhages 
  • Produced due to rupture of the intra alveolar partitions beneath the pleura.
  • More prominent over the lower lobes and interlobar surfaces.
• The lungs are ballooned up, edematous, heavy and boggy.
• They are doughy and spongy
• The margins of both lungs completely appose to each other, thereby covering the pericardium.
• Emphysema aquosum
  • On cut section crepitus like feeling is present due to entrapment of water. 
  • The condition develops only when the conscious victim of drowning struggles for survival.
• Rib markings can also be seen over the boggy and voluminous lungs.

Dry drowning

• Such changes are not seen and usually non-specific signs of asphyxia are present.

• In salt water drowning, lungs are much more edematous than fresh water drowning and appear purple.
• Soft jelly like
• No crepitus
• Copious fluid and froth on sectioning

• The blood is more likely to remain in a fluid state due to prevention of coagulation
• Resulting from the release of plasminogen activator from damaged endothelium of pulmonary capillaries.

• Water may also be detected from middle ear resulting from violent respiratory excursions( conclusion post mortem finding .
• There may be associated hemorrhage from the middle ear as well.

Don’t Forget to Solve all the previous Year Question asked on Drowning-Autopsy findings
Click Here to Start Quiz