Diatoms Found in Water Recovered from Sphenoid Sinus in Cases of Ante Mortem Drowning-An Autopsy Based Cross-Sectional Study

Drowning is a form of asphyxia caused by submersion in water or fluid. Diatoms are commonly used in determining drowning deaths. Smaller diatoms can enter blood circulation and migrate to other organs. Inhaled water enters the lungs and blood circulation, transporting diatoms to organs and potentially entering respiratory sinuses like ethmoid and sphenoid, which can be easily withdrawn.

Total 100 cases of drowning were studied during period of one year. All cases brought to the mortuary of Civil Hospital, Ahmedabad with an alleged history of drowning were included. Decomposed dead bodies with a history of drowning were excluded. The sphenoid sinus was punctured, fluid was aspirated, centrifuged, washed, and re-suspended. Phase-contrast microscopy was used to study the morphological characteristics of diatoms.

The majority of drowning cases were seen among men (87%), with the majority occurring between the ages of 21 to 30 (39%). 67 victims had fluid in their sphenoid sinuses. 79% of cases exhibited froth from the mouth and nostrils. Diatoms were found in 60 instances when fluid was found in the sphenoid sinus, accounting for 89.55% of cases. Sehrt's sign in the stomach was found in 29% of cases. The washerwoman effect was seen in 45% of cases. Water in the stomach was seen in 40% of cases. Rib impression over the lungs were observed in 81% of cases.

Autopsy results show drowning-related cases necessitate opening paranasal sinuses for fluid presence, with diatoms indicating drowning as the cause of death.