Reijnen Guido, Vos Petra, Buster Marcel, Reijnders Udo
Amsterdam Public Health Service, Rijnstate Hospital Arnhem, the Netherlands.
Rijnstate Hospital Arnhem, the Netherlands.
J Forensic Leg Med. 2019 Feb;61:40-44. doi: 10.1016/j.jflm.2018.11.004. Epub 2018 Nov 10.
It is difficult to differentiate drowning from postmortem submersion. Pulmonary foam can be found in bodies retrieved from water. It is unknown whether foam is a result of drowning or if it also forms after postmortem submersion. We divided deceased piglets into three groups: postmortem saltwater submersion (N = 20), postmortem freshwater submersion (N = 20) and dry-land controls (N = 20). All carcasses underwent endoscopic examination within 24 h of death and the presence of external and internal pulmonary foam was scored. No external foam was detected in the postmortem freshwater or the postmortem saltwater group. Internal foam was seen in 35% of the postmortem freshwater and 40% of the postmortem saltwater group. No external or internal foam was detected in the dry land control group. The literature shows external as well as internal foam in drowned humans. Internal foam is seen in postmortem submersion in the current piglet study and antemortem submersion in the literature in humans, and can therefore not be used to support/refute the diagnosis of drowning. No external foam was present in the postmortem submersed piglets, yet has been described in drowned humans. Hence the presence of external foam in bodies recovered from water may be indicative for drowning. The presence of external foam is a potentially valuable clinical sign in distinguishing drowning from postmortem submersion.
很难区分溺水和死后浸水。在从水中打捞的尸体中可发现肺泡沫。尚不清楚泡沫是溺水的结果，还是在死后浸水后也会形成。我们将死亡仔猪分为三组：死后盐水浸泡组（N = 20）、死后淡水浸泡组（N = 20）和陆地对照组（N = 20）。所有尸体在死亡后24小时内接受内镜检查，并对外部和内部肺泡沫的存在情况进行评分。在死后淡水组或死后盐水组中未检测到外部泡沫。在35%的死后淡水组和40%的死后盐水组中可见内部泡沫。在陆地对照组中未检测到外部或内部泡沫。文献显示溺水者体内有外部和内部泡沫。在当前的仔猪研究中，死后浸水可见内部泡沫，在人类文献中生前浸水也可见内部泡沫，因此不能用其来支持/反驳溺水诊断。死后浸泡的仔猪中没有外部泡沫，但在溺水者中已有描述。因此，从水中打捞的尸体中存在外部泡沫可能提示溺水。外部泡沫的存在是区分溺水和死后浸水的一个潜在有价值的临床体征。
