Structural abnormalities in the human diaphragm in drowning and hanging deaths: preliminary results

• Published in: Forensic science, medicine, and pathology Vol. 16; no. 2; pp. 265 - 271
• Main Authors: Girela-López, Eloy, Beltran-Aroca, Cristina M, Jimena, Ignacio, Pérez-Jorge, Pablo, Ramos-Medina, Valentin, Ruz-Caracuel, Ignacio, Gill, James R, Peña-Amaro, Jose
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.06.2020; Springer
• Subjects: Animal experimentation; Asphyxia - pathology; Cadaver; Criminology and Criminal Justice; Death, Sudden, Cardiac - pathology; Diaphragm - pathology; Drowning - pathology; Female; Forensic Medicine; Heart; Humans; Male; Medicine; Medicine & Public Health; Microscopy; Middle Aged; Muscle Fibers, Skeletal - pathology; Muscles; Neck Injuries - pathology; Niacinamide; Original Article; Pathology; Pectoralis Muscles - pathology; Phosphatases; Psoas Muscles - pathology; Drowning; Ragged red fibers; Sudden cardiac death; Hanging; Cytoarchitectural changes; Skeletal muscle
• ISSN: 1547-769X; 1556-2891
• DOI: 10.1007/s12024-020-00235-2

Purpose Previous experiments in rats have indicated that there are histological changes in skeletal muscle in drowning deaths; these changes include muscle fibers that contain ragged red fibers (RRF). The purpose of this study was to examine whether these changes also occur in humans. Methods Histologic and histochemical examinations of three muscles (diaphragm, pectoralis, and psoas) were performed on 24 cadavers with three different causes of death: 8 drowning, 8 hanging, and 8 sudden cardiac disease. Muscle samples were stained with hematoxylin-eosin, MGT, nicotinamide adenine dinucleotide-tetrazolium reductase, succinate dehydrogenase, ATPase, and acid phosphatase via standard staining procedures. Results There were statistically significant differences in the detection of RRFs in these cohorts. Additionally, several other cytoarchitectural changes (whorled and core-like fibers) were observed in the diaphragm in the drowning cohort and to a lesser extent in the hangings. These structural abnormalities were not observed in the sudden cardiac disease deaths, thus suggesting a common mechanism for the production of these muscular changes that is not shared in the cardiac death group. The mechanism is most likely intense hypoxia and mechanical trauma of the respiratory muscles in the setting of active blood circulation with intense muscle contraction. Conclusions Our results confirmed that there are histological changes in the diaphragm in drownings and, to a lesser extent, in hangings.