In a living patient, a hemotympanum can be a sign of a temporal bone f
racture. Postmortem endoscopy in forensic autopsy cases also revealed
hemotympanum findings without any fracture. Thoracic compression or cr
anio-facial congestion were probably the pathogenetic mechanism in som
e of the cases. An engorgement of the internal and external jugular ve
ins was found in all cases. Due to increased intravenous and intraarte
rial pressure, capillary hemorrhages were revealed in endoscopy and hi
stological sections.