Antemortem vs postmortem bruises
In some cases, which are brought dead or are dead
on arrival, the attending doctor often is not able to differentiate between
antemortem bruise and postmortem artefact and the postmortem bruise is often
entered in MLC as injuries. I have seen several such cases in AIIMS during
conduction of autopsies. However, with closer examination, it is possible to
differentiate between the two.
In antemortem bruises, there is swelling and damage to epithelium, coagulation and infiltration of the tissues with extravasated blood and color changes. These signs are always absent in postmortem bruises.
Contusions and abrasions produced immediately after death show a very low degree of changes. Appreciable bruising does not occur after 2–3 minutes of death due to arrest of heart and blood circulation; but, small bruises can be produced up to 3 hours after death by using great force where the tissue can be forcibly compressed against the bone or if the body is dropped on the ground from a height or from transport trolleys or running vehicle. Some of the evidences of bleeding are seen without history of trauma due to tearing of small veins in the skin when the body is lifted from the scene of death and during transportation; the same is called postmortem artifact.
In antemortem bruises, there is swelling and damage to epithelium, coagulation and infiltration of the tissues with extravasated blood and color changes. These signs are always absent in postmortem bruises.
Contusions and abrasions produced immediately after death show a very low degree of changes. Appreciable bruising does not occur after 2–3 minutes of death due to arrest of heart and blood circulation; but, small bruises can be produced up to 3 hours after death by using great force where the tissue can be forcibly compressed against the bone or if the body is dropped on the ground from a height or from transport trolleys or running vehicle. Some of the evidences of bleeding are seen without history of trauma due to tearing of small veins in the skin when the body is lifted from the scene of death and during transportation; the same is called postmortem artifact.
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