有時間嘅可以睇睇有關溺水文獻:
https://jcp.bmj.com/content/jclinpath/45/8/654.full.pdf
Google 翻譯左一段 大家可以參考下:
浸入水中後死亡的發現和解釋
重要的是要將區分 因溺水引致死亡的直接變化(此處討論)與 純粹溺水的變化(之後討論)。此處描述(人體)的變化在標準教科書中有詳細記錄,而評論文章則是以剛剛逝世的人體, 指的是在腐爛發生前已經從水中移除的人體. 的變化。 如已經腐爛了一段時間, 就可能很難進行確切判斷。
溺水
從外部看,儘管可以分辨出幾種變化,但亦有可能沒有明顯特徵。有時口腔或鼻孔中會出現堅韌的泡沫。通常是白色或淡紅色,擦拭後會重新出現,這泡沫被認為是空氣,液體,黏液和水中浮物的混合物,因此這是有死前現象。
在體內的泡沫,即使從外面看不明顯,也經常在主氣管或支氣管和細支氣管中發現。氣道中也可能有水以及外來物質, 如泥沙,雜草或沙。 相似的物質(尤其是水),可能會被吞下並在胃中發現。 在不同的水源溺水, 肺部的變化會有所不同,但這些變化通常未必如一些教科書所指的那樣明顯或有明顯因果關係。
在淡水溺水
通常肺部是正常重量的幾乎兩倍,有時仍被稱為“肺氣腫”,肺部會膨脹且過度擴張(以至於它們可能與心包囊重疊並在中線相遇),並且具有非常獨特, 類似麵團質地, 這在手指壓力下會凹陷,有時會在肋骨範圍有明顯痕跡。典型的上皮出血不常見,但可能會發現較大範圍的胸膜下和肺內出血。肺部切片會釋放出泡沫狀的,經常帶血的液體。在其他地方,(因淡水)血液稀釋會導致血液顯得“水樣”。溶血可能會導致主要血管內膜染血紅色。
Findings and interpretations in deaths after submersion in water
It is important to distinguish changes directly attributable to death following submersion (discussed here) from those which purely reflect immersion (discussed later).The changes described here, which are well documented in standard textbooks and review articles are those encountered in fresh bodies that is, those removed from the water before decomposition becomes established; once a lengthy delay has occurred, positive diagnosis may be difficult.
DROWNING
Externally, although a range of changes maybe identified, there may be nothing specific to drowning. Sometimes, however ,firm tenacious foam is present at the mouth or nostrils. Typically, it is white or blood tinged, and reappears after wiping away.It is thought to represent an admixture of air, fluid, mucus and surfactant, and therefore an ante mortem phenomenon.
Internally, the foam, even if not apparent externally, is often found in major airways or secondary bronchi and bronchioles.The airways may also contain water and such extrinsic materials as silt, weeds, or sand. Similar substances (particularly water) may be swallowed and thus identified within the stomach. Pulmonary changes vary according to the drowning fluid, although they are often not as distinct as suggested by differences in causative mechanisms and as implied in some textbooks.
Fresh water
Typically, the lungs are almost twice their normal weight, and present an appearance sometimes still designated "emphysema aquosum" they are bulky and overdistended (such that they may well overlap the pericardial sac and meet in the midline), with a very characteristic doughy texture which causes them to pit on digital pressure and sometimes to show prominent rib markings. Classic petechial haemorrhages are uncommon, but larger subpleural and intrapulmonary haemorrhages may be identified. Section releases frothy, often blood tinged fluid. Elsewhere, haemodilution causes the blood to appear rather"watery"; haemolysis may produce intimal staining of major vessels.