Emedinews:Insights on Medicolegal Issues:Antemortem vs postmortem injury

• The injuries which are received in the body prior or before death is called the antemortem injury in medicine. These injuries may be a contributing factor in the death or even its cause however on the other hand, they may have occurred many days/months or years ago too.
• During the autopsy, surgeon assesses the age of antemortem injuries, as well as distinguishes them from postmortem injuries, which occur after death. Postmortem injury can be from various sources such as deliberate mutilation of a body by a murderer following a homicide, predation by wild animals, or careless handling in the mortuary. Postmortem injuries can cause confusion over the manner and cause of death.
• One major difference between an antemortem and a postmortem injury is the presence of signs of bleeding. While the person is still alive, the blood is circulating and any injuries such as cuts or stabs will bleed. After death, the body usually does not bleed. However, there are exceptions. For instance, when a person drowns, their body usually floats face down and these results in the head becoming congested with blood.
• Careless handling of a cadaver may produce some post-mortem bruising which may need to be distinguished from ante mortem bruising. Blood also tends to pool under gravity after death, causing a bruised appearance in the lower limbs, arms, hands, and feet known as discoloration. Some of the smaller vessels may even hemorrhage under the pressure of this pooled blood. These bruises could be confused with antemortem bruising.
• If the cadaver receives a head injury by colliding with blunt object/force, then there could be some evidence of bleeding. Scalp wounds sustained after death may also leak some blood. It can be especially difficult to distinguish between injuries inflicted in the very last few minutes of life and those caused postmortem. If the person collapses, there may be areas of laceration to the head and scalp which may be very hard to interpret.
• Recent research has focused on improved techniques for distinguishing between an ante mortem and a postmortem injury by analyzing damaged tissue. Antemortem injuries show signs of inflammation, while postmortem injuries do not. Some research suggests that tissue from ante mortem injuries contains a chemical involved in inflammation leukotriene B4 (LTB4). Postmortem injuries were found to have no LTB4. This could help in more accurate assessment of injuries.