Spleen findings in drowning

A retrospective study of spleen findings in 42 victims of drowning and a comparison group of 42 cases of asphyxiation due to other causes (hanging, ligature strangulation and manual strangulation), that were matched for sex, age, body weight and build, was performed. Significantly smaller spleen weights (P < 0.05), spleen weight:body weight ratios (P < 0.01) and spleen weight:liver weight ratios (P < 0.01) were found in the victims of drowning. The difference in weight was 18%. A significant negative correlation between spleen weight and blood alcohol concentration was found in the study group (r = −0.44; P < 0.01), but not in the control group. The possibility that the findings are due to a stress reaction caused by hypoxia in the presence of cooling and an influence of alcohol on reflex mechanisms is discussed

Letale Komplikation eines Kolon-Kontrasteinlaufs durch Fehllage des Einlaufschlauchs in der Vagina

Bei einer 68 Jahre alten Frau sollte wegen rezidivierender krampfartiger Unterbauchbeschwerden eine Kolon-Kontrastdarstellung durchgeführt werden. In der Anfangsphase der Untersuchung sah der verantwortliche Radiologe bei der Durchleuchtungskontrolle einen Kontrastmittelstopp im Bereich des eingeführten Schlauchendes. Unter der Annahme eines Passagehindernisses erhöhte er den Kontrastmittel-Einlaufdruck. Daraufhin kam es plötzlich zu einem therapieresistenten Schock, und die Patientin starb. Die Obduktion ergab, daß es bei unbemerkter Fehllage des Einlaufschlauchs in der Scheide zu einem Vaginalwandriß mit subperitonealer Kontrastmittelinfiltration gekommen war. Radiologisch und histologisch konnte eine Kontrastmittelembolie in die Lunge nachgewiesen werden. Als Todesursache war das Zusammenwirken der Embolie mit einem peritoneal ausgelösten vagalen Schockzustand anzunehmen.A 68-year-old woman was to have a barium enema of the colon to discover the cause of recurrent cramp-like symptoms in the lower abdomen. At the beginning of the examination the responsible radiologist saw, during a fluoroscopic check, that the contrast medium had not advanced beyond the region of the infusion catheter tip. Believing this to be due to blockage in the catheter he increased the infusion pressure. Suddenly the patient went into treatment-resistant shock and died. The autopsy revealed that the infusion catheter had by mistake been placed into the vagina. This had caused a tear in the vagina with resulting subperitoneal contrast-medium infiltration. Embolization of contrast medium to the lung was demonstrated both histologically and radiologically. The cause of death was the combined effect of the embolism and peritoneally induced vagal shock

Spleen findings in drowning

A retrospective study of spleen findings in 42 victims of drowning and a comparison group of 42 cases of asphyxiation due to other causes (hanging, ligature strangulation and manual strangulation), that were matched for sex, age, body weight and build, was performed. Significantly smaller spleen weights (P < 0.05), spleen weight:body weight ratios (P < 0.01) and spleen weight:liver weight ratios (P < 0.01) were found in the victims of drowning. The difference in weight was 18%. A significant negative correlation between spleen weight and blood alcohol concentration was found in the study group (r = −0.44; P < 0.01), but not in the control group. The possibility that the findings are due to a stress reaction caused by hypoxia in the presence of cooling and an influence of alcohol on reflex mechanisms is discussed