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Abstract

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Article in Japanese

Case Report

An autopsy case of acute respiratory distress syndrome from drowning

Takashi Yamamotoa,b  Nanako Tsutsuib  Toshihiro Kazawab  Mayumi Sasagawab  Gen Watanabec  Kaori Watanabec 

aInternal Medicine, Toyosaka Hospital
bRespiratory Medicine, Nanbugo General Hospital
cDivision of Molecular and Diagnostic Pathology, Niigata University Graduate School of Medical and Dental Sciences

ABSTRACT

A 77-year-old male with no past history was found with his face immersed in a bathtub of water. When he was transferred to our hospital by ambulance, he had disturbance of consciousness and respiratory failure. His condition gradually improved after admission. However, on day 8 after admission he had a high fever and his respiratory condition suddenly worsened. We diagnosed acute respiratory distress syndrome (ARDS) from drowning; thereafter, noninvasive positive pressure ventilation support was started with steroid pulse therapy and continuous infusion of sivelestat. Despite our best endeavors, his condition worsened, and he died of respiratory failure 20 days after admission. An autopsy was performed with informed consent of his family. The lung exhibited the macrofinding of usual ARDS, and microscopic examination revealed an organized phase of diffuse alveolar damage with loss of alveolar epithelium of lots of alveoli, although no hyaline membrane was observed. There have been almost no autopsy cases of ARDS after drowning reported so far; therefore we are reporting this case that we experienced in our hospital.

KEYWORDS

Drowning  Acute respiratory distress syndrome  Diffuse alveolar damage 

Received 13 Dec 2015 / Accepted 23 Jul 2016

AJRS, 5(6): 321-325, 2016

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