Korean J Leg Med.  2012 May;36(1):97-101. 10.7580/KoreanJLegMed.2012.36.1.97.

Alveolar Siderophages : A Precipitating Factor in a Fatal Scuba Diving Accident?: An Autopsy Case

• Kim YS

• KMID: 2250324
• DOI: http://doi.org/10.7580/KoreanJLegMed.2012.36.1.97

Abstract

The author report the case of a 40-year-old male leisure scuba diver (height, 176 cm; weight, 73 kg) who died from asphyxiation by aspiration of gastric content, allegedly triggered by pulmonary hemosiderosis and/or full stomach. On the first dive of the day, the deceased complained of difficulty in descent and tried to descend several times but finally gave up and separated from his companions. After several minutes of separation, he was found dead, face down position on the sea surface, by the captain of the boat carrying the diving party. On autopsy, the lungs showed foreign bodies from stomach, intra-alveolar hemorrhage, and siderophages in the alveolar sac. A small amount of air bubbles was noted in the mesenteric vein, iliac artery, right ventricle and pulmonary artery. The cause of death was asphyxiation by aspiration of gastric content and pulmonary hemosiderosis, which probably provoked the event. Alveolar hemosiderosis may be a causal factor in fatal scuba diving accident.

Keyword

scuba; asphyxiation; aspiration; intraalveolar hemorrhage; hemosiderosis; autopsy

MeSH Terms

Adult
Autopsy
Cause of Death
Diving
Divorce
Foreign Bodies
Friends
Heart Ventricles
Hemorrhage
Hemosiderosis
Humans
Iliac Artery
Leisure Activities
Lifting
Lung
Lung Diseases
Male
Mesenteric Veins
Precipitating Factors
Pulmonary Artery
Ships
Stomach
Hemosiderosis
Lung Diseases

Figure

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  Fig. 1 Autopsy showed large amount of regurgitated gastric content in the oropharynx.

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  Fig. 2 On cut surface of the lung, hemorrhage and edema were revealed.

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  Fig. 3 Histologic section of the lung showed brown-pigmented macrophages and aspirated food material (H & E ×100).

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  Fig. 4 Macrophages in alveolar spaces showed positive reaction with Iron stain (Prussian blue ×400).

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  Fig. 5 After manual removal of mesenteric fat, air bubbles were noted in the mesenteric vein.

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