Diagnosis of drowning using post-mortem computed tomography – state of the art

Aim of the study: Recent studies using post-mortem computed tomography (PMCT) have suggested this imaging modality is of value in the positive diagnosis of drowning. We summarize the data from the literature regarding the diagnostic value of CT in cases of drowning.

Material and methods: We performed an all-language search of literature published from 1999 to 2013 with the key words “post-mortem CT scan”, “drowning and CT scan”, “near-drowning diagnosis”, and “drowning diagnosis”.

Results: Only 11 articles, whose data enabled complementary statistical analysis, were included. The presence of fluid and sediment in paranasal sinuses appear to be the determinants of the diagnosis of drowning. The presence of fluid in the sinuses had a sensitivity of 100%, and of 90% in the trachea and main bronchi. The results were completed by the high specificity of the presence of sediment in the paranasal sinuses, upper airways and stomach, which was 100% for all three. Haemodilution was present in cases of drowning (p < 0.001). The values made it possible to formulate a decision algorithm for the diagnosis of drowning.