Bodies Recovered from Water: a Personal Approach and Consideration of Difficulties 657
6545 JClin Pathol 1992;45:654-659 Bodies recovered from water: a personal approach and consideration of difficulties J Clin Pathol: first published as 10.1136/jcp.45.8.654 on 1 August 1992. Downloaded from W Lawler Introduction It has been reported that about 85-95% of For the pathologist providing a routine nec- those dying from water inhalation present ropsy service to the local coroner, examination features of drowning,59 although in most, not of bodies recovered from water can generate all the typical features are seen9; the remainder the most difficult of interpretational problems, die from vagal inhibition (sometimes, inaccu- and this is probably the prime context where rately, known as "dry drowning", and once appropriate historical and circumstantial evi- designated "hydrocution"), or the post dence is vital to interpretation and overall immersion syndrome; perhaps, rarely, laryn- conclusions,' 2 although such collateral evi- geal spasm may be important. dence should always be available before any At this stage, it is worth remembering that coroner's necropsy is undertaken.3 hypothermia can supervene very quickly in It must be appreciated, at the outset, that individuals swimming or trying to remain not all persons whose bodies are recovered afloat in cold water, and that it may be an from water will have died from its inhalation, important factor contributing to their although they may show features reflecting death'0 "; indeed, hypothermia may be the immersion in water. Such bodies should there- main cause of death after shipwreck in the fore be particularly carefully examined, both open sea.1 12 externally and internally, to catalogue (and subsequently to explain satisfactorily) all inju- DROWNING ries present, to determine whether death Mechanisms for death from drowning are indeed followed immersion in the water, and to multiple, complex, and, in part, still incom- see whether any natural disease, such as pletely understood.
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