title: Spa-drain entrapment complicated by suspicions of nonaccidental trauma and epilepsy onset.
abstract: We present here the case of an adolescent female near-drowning victim who was reportedly discovered submerged and unconscious by family members in a whirlpool spa. Physical examination revealed extensive posterior soft tissue bruising, which raised the suspicion of nonaccidental trauma. Detailed forensic evaluation of the injuries and the scene proved that the soft tissue findings represented an unusual manifestation of whirlpool-spa suction-vent injury. Medical evaluation indicated that epilepsy onset might have contributed to the near-drowning, although forensic evaluation of this possibility was less convincing. In this article we review these rare but important injuries, which have the potential to be confused with child abuse, and detail the atypical presentation and clinically presumed etiologic event in our case.
authors.affiliation: University Children's Hospital Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland. matthias.furter@kispi.uzh.ch
authors.forename: Matthias
authors.initials: M
authors.lastname: Furter
authors.forename: Tanja
authors.initials: T
authors.lastname: Germerott
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Thali
mesh_terms: D019567:Back Injuries / Q000209:etiology; D002648:Child; D002649:Child Abuse / Q000175:diagnosis; D003288:Contusions / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006875:Hydrotherapy / Q000009:adverse effects*; D015701:Near Drowning / Q000209:etiology*; D017695:Soft Tissue Injuries / Q000209:etiology