Korean J Leg Med.  2019 Nov;43(4):129-137. 10.7580/kjlm.2019.43.4.129.

Evaluation of Sodium and Chloride Biochemical Tests in Drowning Autopsy Cases

• Na JY
• Oh YH

• KMID: 2464490
• DOI: http://doi.org/10.7580/kjlm.2019.43.4.129

Abstract

There are several diagnostic findings required for confirming a postmortem diagnosis of drowning. However, postmortem diagnosis of drowning remains challenging for forensic pathologists. In previous reports, several biochemical tests using various body fluids have been studied for their potential use in the postmortem diagnosis of drowning. In this study, the concentration of sodium and chloride was tested in various postmortem body fluids (vitreous humor, sphenoid sinus fluid, pleural fluid, cerebrospinal fluid, etc.) and their results were interpreted for their potential use in postmortem diagnosis of drowning. We examined 67 autopsy cases (freshwater drowning, 12 cases; seawater drowning, 16 cases; control group, 39 cases). The sodium and chloride concentration in the vitreous humor, sphenoid sinus fluid, and pleural fluid significantly correlated with each other. Furthermore, the concentrations of sodium, chloride, and the sum of the concentrations of the two in the various postmortem body fluids were significantly different in the three groups, when compared with each other (generally the concentration being the highest in the seawater drowning group, followed by the control group and the freshwater drowning group). Biochemical tests using various postmortem body fluids may serve as useful indicators for the postmortem diagnosis of drowning and for the differential diagnosis between freshwater and seawater drowning.

Keyword

Drowning; Body fluids; Biochemistry; Autopsy

MeSH Terms

Autopsy*
Biochemistry
Body Fluids
Cerebrospinal Fluid
Diagnosis
Diagnosis, Differential
Drowning*
Fresh Water
Seawater
Sodium*
Sphenoid Sinus
Vitreous Body
Sodium

Figure

• 

  Fig. 1 Box plots of the concentration of electrolytes (A, Na, sodium; B, Cl, chloride; C, sum of sodium and chloride) in the vitreous humor of the three groups (freshwater drowning, seawater drowning, and control groups). Among the three groups, the concentration of electrolytes in the vitreous humor of the seawater drowning group was significantly higher than that of the freshwater drowning and control groups.

• 

  Fig. 2 Box plots of the concentration of electrolytes (A, Na, sodium; B, Cl, chloride; C, sum of sodium and chloride) in the sphenoid sinus fluid of the three groups (freshwater drowning, seawater drowning, and control groups). Among the three groups, the concentration of electrolytes in the sphenoid sinus fluid was significantly different in each group.

• 

  Fig. 3 Concentration of electrolytes (A, Na, sodium; B, Cl, chloride) is significantly correlated between in the vitreous humor and sphenoid sinus fluid (A, r=0.696, P<0.001; B, r=0.759, P<0.001).

• 

  Fig. 4 Box plots of the concentration of electrolytes (A, Na, sodium; B, Cl, chloride; C, sum of sodium and chloride) in the pleural fluid of the two groups (freshwater and seawater drowning group). The concentration of electrolytes in the pleural fluid was significantly different between the 2 groups.

• 

  Fig. 5 The concentration of electrolytes (A, Na, sodium; B, Cl, chloride) is significantly correlated between the pleural fluid and sphenoid sinus fluid (A, r=0.831, P<0.001; B, r=0.729, P=0.003).

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