Post-mortem computer tomography in ten cases of death while diving: a retrospective evaluation.

Area of Science:

• Forensic Pathology
• Radiology
• Diving Medicine

Background:

• SCUBA diving fatalities pose challenges for forensic pathology.
• Post-mortem CT (PMCT) aids in diagnosing arterial gas embolism (AGE) by visualizing gas.
• Current literature suggests PMCT for AGE diagnosis should occur within 24 hours of death.

Purpose of the Study:

• To evaluate the utility of PMCT in diagnosing AGE in SCUBA divers.
• To assess if PMCT is effective when performed 24-48 hours post-mortem.
• To identify specific gas distribution patterns indicative of AGE in delayed PMCT examinations.

Main Methods:

• Retrospective analysis of 32 post-mortem CT cases (2011-2021), including 10 SCUBA divers.
• Cases included those examined 24-48 hours after death.
• Radiological images were reviewed for intracorporeal gas distribution and other SCUBA-related findings, with semi-quantitative evaluation.

Main Results:

• SCUBA divers frequently showed gas in the left heart and arteries.
• Divers had a higher mean amount of intraarterial gas compared to fresh corpses.
• Putrefied corpses showed significantly more portal system gas and subcutaneous emphysema than divers.

Conclusions:

• PMCT is a valuable tool for diagnosing AGE in SCUBA divers, even when performed 24-48 hours post-mortem.
• A medium quantity of intraarterial gas, without extensive portal or subcutaneous emphysema, may indicate AGE.
• Further research with larger sample sizes is warranted to confirm these findings.