Macromorphology and histology of intramuscular hemorrhages in cases of drowning.

In a prospective autopsy series of 39 cases of fatal drowning, the detailed dissection of the skeletal muscles of the neck, anterior/posterior trunk and the upper extremities in layers revealed intramuscular hemorrhages of different size and shape in 20 cases (51.3%). Light microscopy examination showed a premortal (vital/agonal) type of muscular alteration in 7 (50%) out of 14 macroscopical hemorrhage-positive cases. These hemorrhages and histological muscle alterations are attributed to agonal convulsions, hypercontraction and overexertion of the affected muscle groups. As long as no cutaneous or subcutaneous hematomas above the hemorrhages can be found, these autopsy findings (with special reference to histology) can serve as an additional criterion concerning the differentiation of drowning and another cause of death.