POSTMORTEM EXTRAVASATION OF BLOOD POTENTIALLY SIMULATING ANTEMORTEM BRUISING

A case of florid postmortem extravasation of blood, potentially simula ting antemortem bruising, is presented. A 98-year-old woman died in ho spital, the cause of death being certified as congestive cardiac failu re. After burial, it was apparent that the grave had been disturbed by crowbars and shovels. Exhumation was performed and autopsy revealed c onsiderable apparent facial bruising as well as lacerations and fractu res. There was no documentation by the medical or nursing staff of any injuries to the deceased preceding death. There was also no documenta tion of injury by the funeral directors. Subsequently, two men admitte d to removing the body from the grave and mutilating it. Thus, what wa s apparently facial bruising was, in fact, postmortem extravasation of blood simulating antemortem bruising. The degree of extravasation was considered to be related to the severity of the injuries, loose subcu taneous tissues of the head and neck, and dependent position of the bo dy upon return to the grave. This case demonstrates the degree of post mortem extravasation of blood that may occur in particular circumstanc es and may simulate antemortem bruising. In other circumstances, the p ostmortem extravasation of blood may well have led investigators to pu rsue inquiries regarding homicide.