Monday, 6 May 2013

Emedinews:Insights on Medicolegal Isues:Difference between antemortem and postmortem bruises


Medicolegal Update
(Dr Sudhir Gupta, Additional Prof, Forensic Medicine & Toxicology, AIIMS)

  • Some people bruise easily, whereas others may have tougher skin tissue. Apply a cold compress to the bruise for at least 10 minutes to reduce swelling or the amount of bruising after an injury,
  • In some cases of brought dead or dead on arrival, the doctor attending the case in emergency may be confused or is not be able to differentiate between antemortem bruise and postmortem artifact and the postmortem bruise is recorded in MLC report as injuries. I have seen such cases in AIIMS during autopsy.
  • Close examination by doctor in emergency may help to differentiate because in antemortem bruises there is swelling and damage to epithelium, coagulation and infiltration of the tissues blood and color changes. These signs are always absent in postmortem bruises.
  • It is seen that 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 by using great violence small bruises can be produced up to 3 hours after death 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 transportation handling and the same is called postmortem artifact.

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