Emerging issues in the approach to submerged bodies: Water-related deaths in Friuli, northeastern Italy (1993–2020). Analysis of post-mortem reports and some unusual cases.

This article focuses on the forensic investigation of water-related deaths based on a 28-year retrospective review of autopsy records from Friuli, northeastern Italy. Among 69 fully autopsied cases, drowning was the leading cause of death, but challenges arose due to nonspecific autopsy findings, putrefaction, and difficulties in interpreting post-mortem blood alcohol concentrations (BACs), which may be affected by endogenous ethanol production. The study highlights that emphysema aquosum and external foam are the most reliable morphological indicators of drowning, though their presence can be diminished by prolonged submersion and decomposition. Additionally, the article discusses the ambiguous definitions of "wet" and "dry" drowning and underscores the complexity of determining cause and manner of death in submerged bodies, emphasizing the need for cautious interpretation of autopsy and toxicological data in forensic practice.