Korean J Leg Med.  2014 Nov;38(4):171-174. 10.7580/kjlm.2014.38.4.171.

Diver Death due to Underwater Explosion

• Na JY
• Park JW
• Yoon SH
• Park JS
• Choi BH
• Kim YS

• KMID: 1928011
• DOI: http://doi.org/10.7580/kjlm.2014.38.4.171

Abstract

A 44-year-old man was cutting an outer plate of a ship, at a depth of 25 m below sea level. Following a sudden explosion, he was discovered unconscious and was carried to the surface by other divers. There was no evidence of vital signs upon arrival at the hospital. Postmortem computed tomography, which was performed prior to autopsy, revealed massive pneumocephalus in the brain, pneumohemothorax, diffuse lung contusions with multiple traumatic lung cysts, air-fluid level in the cardiac chamber of the chest, and pneumoperitoneum in the abdomen. Postmortem external examination showed a circular abrasion on the jaw, diffuse subcutaneous emphysema, and contusion in the right upper arm. An internal examination revealed intravascular air bubbles in all four chambers of the heart, and diffuse pulmonary trauma including contusion, laceration, and multiple traumatic cysts. Blast injury to the chest, and air embolism due to the underwater explosion were established as the underlying cause of death.

Keyword

Air embolism; Blast injury; Diving; Autopsy

MeSH Terms

Abdomen
Adult
Arm
Autopsy
Blast Injuries
Brain
Cause of Death
Contusions
Diving
Embolism, Air
Explosions*
Heart
Humans
Jaw
Lacerations
Lung
Pneumocephalus
Pneumoperitoneum
Ships
Subcutaneous Emphysema
Thorax
Vital Signs

Figure

• 

  Fig. 1. Brain computed tomography shows a massive pneumocephalus and air in the cerebral vessels and subcutaneous tissue (a). Chest computed tomography shows a massive subcutaneous emphysema, pneumo-hemothorax, pneumomediastinum, multiple traumatic lung cysts, and air fluid levels in cardiac chamber and aorta (b).

• 

  Fig. 2. A circular abrasion sized about 2.5 cm in diameter is noted in his jaw (a). And a similar sized circular air-orifice is noted in the diving helmet (b).

• 

  Fig. 3. Gas bubbles present in the superficial cerebral blood vessels (a). Gas bubbles are seen in the heart chambers (b). A massive pulmonary traumas including laceration, hilar rupture, multiple hemorrhagic cysts, and contusion are noted (c).

Reference

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