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International Journal of Legal Medicine

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01-01-2019 | Original Article

Layering of stomach contents in drowning cases in post-mortem computed tomography compared to forensic autopsy

Authors: Walther Gotsmy, Paolo Lombardo, Christian Jackowski, Eva Brencicova, Wolf-Dieter Zech

Published in: International Journal of Legal Medicine | Issue 1/2019

Abstract

Background

In forensic autopsy, the analysis of stomach contents is important when investigating drowning cases. Three-layering of stomach contents may be interpreted as a diagnostic hint to drowning due to swallowing of larger amounts of water or other drowning media. The authors experienced frequent discrepancies of numbers of stomach content layering in drowning cases between post-mortem computed tomography (PMCT) and autopsy in forensic casework. Therefore, the goal of this study was to compare layering of stomach contents in drowning cases between PMCT and forensic autopsy.

Methods

Drowning cases (n = 55; 40 male, 15 female, mean age 45.3 years; mean amount of stomach content 223 ml) that received PMCT prior to forensic autopsy were retrospectively analyzed by a forensic pathologist and a radiologist. Number of layers of stomach content in PMCT were compared to number of layers at forensic autopsy.

Results

In 28 of the 55 evaluated drowning cases, a discrepancy between layering of stomach contents at autopsy compared to PMCT was observed: 1 layer at autopsy (n = 28): 50% discrepancy to PMCT, 2 layers (n = 20): 45% discrepancy, and 3 layers (n = 7): 71.4% discrepancy. Sensitivity of correctly determining layering (as observed at forensic autopsy) in PMCT was 52% (positive predictive value 44.8%). Specificity was 46.6% (negative predictive value 53.8%). In a control group (n = 35) of non-drowning cases, three-layering of stomach contents was not observed.

Conclusion

Discrepancies of observed numbers of stomach content layers between PMCT and forensic autopsy are a frequent finding possibly due to stomach content sampling technique at autopsy and movement of the corpse prior to PMCT and autopsy. Three-layering in PMCT, if indeed present, may be interpreted as a hint to drowning.

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Title: Layering of stomach contents in drowning cases in post-mortem computed tomography compared to forensic autopsy
Authors: Walther Gotsmy
Paolo Lombardo
Christian Jackowski
Eva Brencicova
Wolf-Dieter Zech
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: International Journal of Legal Medicine / Issue 1/2019
Print ISSN: 0937-9827
Electronic ISSN: 1437-1596
DOI: https://doi.org/10.1007/s00414-018-1850-4

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Springer Medicine

Layering of stomach contents in drowning cases in post-mortem computed tomography compared to forensic autopsy

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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