Histologische Lungenbefunde beim Würgen und Drosseln

Zusammenfassung

Anhand einer einfach gehaltenen histologischen Untersuchung (n = 67) wurde der Frage nach der Häufigkeit und den evtl. im Ablauf begründeten Einflußfak-toren für die Entstehung alveolärer Lungenödeme bei Tötungen durch Strangulation nachgegangen. Zwei Drittel der Fälle zeigten ein ausgeprägtes alveoläres Ödem. Ein Unterschied zwischen den Strangulationstypen bestand nicht. Eine Altersabhängigkeit war ebenfalls nicht erkennbar. Bei allein todesursächlicher Halskompression lagen in 83% der Fälle ausgeprägte Ödeme vor, deutlich seltener waren sie bei anderer (54%) oder konkurrierender (38 %) Todesursache. Veränderungen des Inhaltes der Lungengefäße (vermehrt Zellen der weißen Reihe, Plättchenaggregate, Mikrothromben) fanden sich in einem Drittel der Fälle in diskreter und in einem weiteren Drittel in deutlicher Ausprägung. Besonders intensiv waren sie bei unmittelbar todesursächlicher Strangulation, weniger bei an lokalen Läsionen am Hals bereits beginnender Zellreaktion. Tendenziell nahmen sie mit zunehmendem Lebensalter ab.

Zur Ergänzung wurden die Lungengewichte überprüft. Diese lagen überwiegend zwischen 800 und 1400 g und damit oberhalb der sonst angegebenen „Normalgewichte“.

Summary

The development of pulmonary oedema by survivors or death victims of asphyxia or strangulation is common knowledge. There are various publications concerning evaluation of the differences between acute and protracted deaths. In order to differentiate this we evaluated our results, obtained from 76 medicolegal autopsies (20 males, 56 females of all age groups) performed on homicidal throttl-ings and strangulation by ligature. The histological findings in lung tissue were compared with those of the reactions at the site of local injury (larynx). Severe alveolar oedema was found in 44 of the 67 histologically evaluated cases and was found in most of the 41 cases where the cause of death was strangulation alone. Almost half of the cases additionally showed an extravasation of red blood cells into the alveolar space. A distinct congestion was a regular finding.

Hydropic swollen, not rough pigmented, alveolar macrophages were found in 60% of the cases. Their number did not increase with prolongation of autolysis.

A discrete change in the contents of the vessels of the lung (aggregates of platelets, many leukocytes) were shown by one third, and distinct in another third. In the cases where severe oedema developed there were twice the number. In the cases where there was an evident change in the content of the vessels of lungs, a vital reaction of the larynx was more seldom (10 %) compared with the cases without such a finding (30 % with vital reactions of the larynx).

Bunching of leukocytes and/or platelets in haemorrhages of the larynx was often combined with distinct alterations in the lung vessels (80 %). With increasing age the invascular changes of the lung content diminished.

Epithelaxia in the bronchiols was found in 54 cases; in 35 of these, a mixture with air was found. A connection to the duration of autolysis could not be determined.

Additionally the weights of the lungs (adults) were recorded. The average weight of both lungs was 1000 g (min 300 to max 1900 gr) or 1,5% — 2% of body weight. This is more than stated in the literature for “normal” lung weight. A dependence on age was not found.