title: Role of virtopsy in the post-mortem diagnosis of drowning.
abstract: OBJECTIVE
  Due to admitted limits of autopsy-based studies in the diagnosis of drowning, virtopsy is considered the new imaging horizon in these post-mortem studies. The aim of our study was to evaluate the role of virtopsy performed through computed tomography (CT) in the forensic diagnosis of drowning.
  
  
  METHODS
  We retrospectively examined the CT data of four cadavers recovered from sea water and suspected to have died by drowning. Each patient underwent a full-body post-mortem CT scan, and then a traditional autopsy.
  
  
  RESULTS
  All the cadavers showed fluid in the airways and patchy ground-glass opacities in the lung. Only one patient had no fluid in the digestive tract; this patient had a left parietal bone fracture with a large gap and other multiple bone fractures (nose, clavicle, first rib and patella). One of the three patients who had fluid in the digestive tract had no fluid in the paranasal sinuses. This latter patient showed cerebral oedema with subarachnoid and intraventricular haemorrhage, multiple bone fractures (orbital floor, ribs, sacrum and acetabular edge) and air in the heart, in the aorta and in bowel loops.
  
  
  CONCLUSIONS
  To date, there are no autopsy findings pathognomonic of drowning. This study proves that virtopsy is a useful tool in the diagnosis of drowning in that it allows us to understand if the victim was alive or dead when he entered the water and if the cause of death was drowning.
authors.affiliation: Department of Radiology, DIBIMEF, University Hospital P. Giaccone, University of Palermo, Via del Vespro, 129, 90127, Palermo, PA, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lo Re
authors.forename: Federica
authors.initials: F
authors.lastname: Vernuccio
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Galfano
authors.forename: Dario
authors.initials: D
authors.lastname: Picone
authors.forename: Livio
authors.initials: L
authors.lastname: Milone
authors.forename: Giuseppe
authors.initials: G
authors.lastname: La Tona
authors.forename: Antonella
authors.initials: A
authors.lastname: Argo
authors.forename: Stefania
authors.initials: S
authors.lastname: Zerbo
authors.forename: Sergio
authors.initials: S
authors.lastname: Salerno
authors.forename: Paolo
authors.initials: P
authors.lastname: Procaccianti
authors.forename: Massimo
authors.initials: M
authors.lastname: Midiri
authors.forename: Roberto
authors.initials: R
authors.lastname: Lagalla
mesh_terms: D001344:Autopsy / Q000379:methods*; D002102:Cadaver; D002423:Cause of Death; D004332:Drowning; D006801:Humans; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface