A Research Study on Histopathological Changes that are Seen in Lungs of Victims Who Died of Drowning

Abstract

Drowning is considered to be the leading cause of death in water and the third most common cause of 
accidental death worldwide, with the highest drowning rates in developing countries. The WHO defines drowning as the process of experiencing respiratory impairment from submersion/immersion in 
liquid. For forensic experts, death in water is a multifaceted issue presenting a challenge to them. Since all the circumstances from natural death to homicide are possible in the water, critical examination and interpretation of all abnormal findings found during autopsy are of great 
importance.Drowning is a diagnosis of exclusion, based on ruling out all other causes of death via complete 
autopsy and toxicology. Drowning causes hypoxemia, loss of consciousness, apnea and ultimately 
cardiac arrest. Fluid aspiration results in lung injury and acute respiratory distress syndrome. Acute Respiratory Failure is the main component of drowning pathophysiology. Near drowning results 
in multiple complications including aspiration pneumonia which is often life-threatening. Hence the 
histopathological changes in the lungs provide good corroborative evidence of death due to drowning. Nevertheless, for the examined drowning signs, no high diagnostic certainty could be 
observed. However, these findings can increase their diagnostic value if forensic doctors take influencing factors into consideration.
From the central record section of the Department of Forensic Medicine, Siddhartha Medical College, Vijayawada, Andhra Pradesh, about 80 medicolegal postmortem reports of death due to drowning in 
undecomposed bodies were selected in which one whole lung was sent for histopathological examination during the past two years i.e, 2020 - 2022. Parameters like Age, Sex and Marital Status 
were also studied. Histopathological examination of drowned lungs showed that congestion was seen in 92% of cases, oedema in 96% cases, dilatation of alveoli in 86% of cases, thinning of septa was 
seen in 84% of cases rupture of alveoli seen in 64% of cases and hemorrhage is seen in 46% of cases. 
Mostly males are affected and drowning deaths are seen more in 26 – 40 years age group. The histopathological investigations must be performed on all the organs of non-putrefied bodies with 
the aim of making the difference between death by drowning and other causes of death. The lung examinations can show over-distension of the alveoli, thinning of the alveolar septa and compression with narrowing of the capillary network.