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Pediatric Drowning: A 20-Year Review of Autopsied Cases: II. Pathologic Features

Somers, Gino R. MD, PhD*†; Chiasson, David A. MD*†; Smith, Charles R. MD*†

American Journal of Forensic Medicine & Pathology: March 2006 - Volume 27 - Issue 1 - pp 20-24
doi: 10.1097/01.paf.0000201103.67465.6a
Original Article

The pathologic findings in autopsies of drowning victims are nonspecific and vary from case to case. However, most reported pathologic series of drowning cases exclude children and do not take into consideration the unique circumstances surrounding bathtub drownings. In addition, the effect of resuscitation on the autopsy findings has not been studied in children. A retrospective review of autopsy records of nonbathtub drownings from a 20-year period (1984–2003) was performed and 63 cases were identified in 45 males and 18 females (age range 9 months to 17 years). The incidence of frothy exudate, pleural effusion, and increased lung weight was 43%, 36%, and 80%, respectively. The incidence of frothy exudate and the combination of all 3 factors was significantly higher in cases with no resuscitation compared with those cases with attempted resuscitation with or without delayed death. As the interval between the drowning episode and autopsy increased, the incidence of frothy exudate decreased significantly. There was no relationship between these findings and the age and sex of the decedent. Other clinical conditions or occult pathologic findings that may have contributed to death were found in 8 cases (13%). The findings highlight the need for thorough clinicopathologic correlation in cases of drowning to accurately interpret the pathologic findings.

From the *Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada; and the †Department of Pathobiology and Laboratory Medicine, University of Toronto, Toronto, Ontario, Canada.

Manuscript received November 2, 2004; accepted May 24, 2005.

Reprints: Dr Gino R. Somers, Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada, M5G 1X8. E-mail: gino.somers@sickkids.ca.

© 2006 Lippincott Williams & Wilkins, Inc.