title: Svechnikov's sign as an indicator of drowning in immersed bodies changed by decomposition: an autopsy study.
abstract: OBJECTIVE
  Bodies recovered from water often present as a difficult problem in forensic pathology. The aim of this study was to examine the presence and amount of free liquid in the sphenoid sinus in cases of freshwater drowning, and to compare this to the amount found in putrefied bodies recovered from freshwater, as well as in putrefied bodies found in an indoor environment.
  
  
  METHODS
  Free liquid from the sphenoid sinuses was aspirated using a syringe and a needle, after piercing the hypophyseal fossa. Non-putrefied drowning cases were also examined for hemolytic staining of the intima of the aortic root.
  
  
  RESULTS
  In 29 non-putrefied cases of freshwater drowning there was 1.36 ± 1.48 ml in the sphenoid sinuses, with 21 of them having hemolytic staining of aortic intima. In putrefied bodies recovered from freshwater (22 cases) there was 1.26 ± 1.40 ml within the sphenoid sinuses, and in putrefied bodies found in an indoor environment (52 cases), there was significantly less-0.57 ± 0.92 ml.
  
  
  CONCLUSIONS
  Free liquid in the sphenoid sinuses (Svechnikov's sign) may be considered a vital reaction in drowning non-putrefied cases. Hemolytic staining of the aortic intima could be a significant sign of freshwater drowning. In putrefied bodies recovered from water, an amount of 0.55 ml of free liquid in the sphenoid sinuses may imply that the victim was alive upon their contact with the water, but the presence of free liquid in the sphenoid sinuses does not necessarily indicate that drowning had been the cause of death.
authors.affiliation: Institute of Forensic Medicine, University of Belgrade - School of Medicine, 31a Deligradska str., 11000, Belgrade, Serbia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Zivković
authors.forename: Dragan
authors.initials: D
authors.lastname: Babić
authors.forename: Slobodan
authors.initials: S
authors.lastname: Nikolić
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology; D001344:Autopsy; D002423:Cause of Death; D004332:Drowning / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D005260:Female; D049429:Forensic Pathology / Q000379:methods; D005618:Fresh Water; D006461:Hemolysis; D006801:Humans; D007101:Immersion; D008297:Male; D008875:Middle Aged; D011180:Postmortem Changes; D011446:Prospective Studies; D013101:Sphenoid Sinus / Q000737:chemistry* / Q000473:pathology; D013396:Suction; D017539:Tunica Intima / Q000473:pathology; D055815:Young Adult