You are on page 1of 34

LATE POSTMORTEM

CHANGES.

POTMORTEM DECOMPOSITION
PUTREFACTION
Final stage following death.
Produced mainly by action of bacterial
enzymes , mostly anaerobic from
bowel.
Chief bacteria clostridium welchii,
responsible for haemolysis and
liquefaction of clots.
Other bacteria such as streptococci,
staphylococci and Gram ve bacilli.
ct
Other enzymes from fungi such as
penicillium and aspergillus and insects play a
role too.
Bacteria produce a variety of enzymes which
breakdown proteins, carbohydrates and fats.
Lecithinase produced by Cl. welchii
hydrolyses lecithin, present on cell
membranes including red blood cells causing
haemolysis
There is progressive breakdown of soft
tissues with alteration of proteins,
carbohydrates and fats.
Organisms enter the tissues from the
alimentary tract.
The fall in oxygen and rise in
hydrogen ion concentration favours
bacterial growth and spread.
c.f. autolysis = autodigestion.
earliest changes in parenchymatous
glandular organs and brain.
due to lytic enzymes ( proteolytic,
glycolytic and lipolytic) from the cell
itself.
this leads to autodigestion and
disintegration of organs.
autolysis increased by heat and
stopped by freezing or inactivating
enzymes by heat.
earliest changes occur in
parenchymatous and glandular tissues
and brain.
autolytic fermentation is responsible for
maceration of foetus in utero.
Characteristic features of
putrefaction
Changes in colour of tissues.
Bacteria spread directly from the bowel
into tissues of abdominal wall.
Hb diffuses through vessels, staining
reddish brown colour.
Derivatives of Hb formed
(sulphametaHb) gives a greenish-black
colour.
First external sign- skin over caecum
greenish.
Internally under surface of liver.
Colour changes (ct)
Superficial veins stained greenish-
brown, with marble appearance.
Skin slippage and blister formation.
Clotted blood becomes fluid, increasing
postmortem staining.
Bloody fluid collects in serous cavities.
Appearance 12-18 hours.
Foul smelling gases.
Proteins and carbohydrates split into
simpler compounds.
Include amino acids, ammonia, CO2,
H2S, methane, mercaptans.
These gases are non-inflammable in
early stages.
With H2S production, they become
flammable.
ct
Gases collect in intestines 6-12 hours
leading to abdominal distension.
On opening the abdomen, the gas
escapes with a loud explosive noise.
Diaphragm may be pushed upwards by
gases, leading to lung compression.
May cause froth to come from mouth
and nostril ( postmortem surge).
ct
Food from stomach may be forced into
fauces and larynx !!!
Gas accumulation in tissues produces
emphysema, scrotal swelling, bulging
tongue/eyes.
Pregnant uterus may expel foetus.
The gas formation in blood vessels may
force blood stained fluid, air or liquid fat
between epidermis forming blisters
Rigidity due to inflation of tissues with
gases- lower limbs abducted, flexed and
rigid; arms abducted and flexed.
Liquefaction of tissues
Begins 5-10 days or more after death.
Abdomen bursts and stomach and
intestines protrude.
Tissues become soft, thick semi-fluid
material.
Separation from bones finally occurs.
Decomposition may differ from body to
body, environment and from one part of
body to another.
Sometimes one part may be mummified
while another shows liquifaction
.
Skeletonization
Time for this change varies considerably
In exposed body- flies, maggots, dogs
etc within a few days.
In water- water creatures- a few days.
In uncoffined body in shallow grave-
putrefaction delayed for sometime.
In deeply buried body- lower temp,
exclusion of bacteria, absence of animal
life- will markedly delay
skeletonization.
Important determining factors are
seasonal, climatic variation, amount of
soil water, soil acidity and access of air
Internal Phenomenon
Internally, decomposition advances in
the same rate as seen externally
Viscera become greasy and softened

As a general rule, organs show


putrefactive changes in the following
order; larynx and trachea; stomach,
intestines and spleen ;liver and lungs;
brain; heart; kidney in that order.
Conditions affecting the rate of putrefaction:
a. External:
i. Temperature:
Putrefaction begins above 10 and optimum
0

between 210 and 380 C.


It is arrested below 00 C and above 480 C
ii. Moisture:
necessary for this change
iii. Manner of burial.
5. Adipocere (saponification)

Adipocere= wax, a modification of


putrefaction.
Fatty tissues change into soap-like
substance called adipocere.
Most commonly in bodies immersed in
water or damp, warm environment.
Due to gradual hydrolysis and
hydrogenation of preexisting fats.
ct
Fats such olein into higher fatty acids.
These combine with calcium and ammonium
ions to form insoluble soaps.
Being acidic, inhibit putrefactive bacteria.
Ultimately, whole fat converted into palmitic,
oleic, stearic acids, forming adipocere.
The process starts under the influence of
intrinsic lipases, and then continued by
enzymes of Cl. Perfringens
The water required for the hydrolysis is from
body tissues.
With attachment to tissue fibres, nerves and
muscles morphology maintained.
Process delayed by cold and enhanced by
heat.
Properties:
Has a distinct offensive or sweetish smell

But during the early stages has a penetrating


ammoniacal odour
The smell remains in the clothing of those
handling bodies for several days
Ones olfactory sense rapidly becomes

accustomed to the smell of adipocere.


However, the sense of smell returns after a
few minutes in the open air
Distribution:
Any site where there is fat.

First in the subcutaneous tissues

Face, buttocks, breasts and abdomen are

usual sites
Limbs, chest and other parts also involved.
In wide spread adipocere soft tissues
are markedly dry.
Adipocere may persist for decades, but
finally either degenerates or removed
by mechanical forces or by animals.
Time required for its formation:
In temperate countries, shortest time 3
weeks in summer to be seen in some
parts.
Stiffening, hardening and swelling of fat

occurs after 3-4 months


Medico-legal importance:
1. When the process involves the face,
the features are well preserved,
helping identity
2. Cause of death can be determined,
because injuries are recognized
3. The time of death can be estimated.
6. Mummification
A modification of putrefaction.
Evaporation of water leads to
dehydration or drying and shriveling of
cadaver.
A result of evaporation of body water.
Natural features of body preserved.
Begins in exposed parts of body - face,
hands and feet.
ct
Then entire body including internal organs.
Skin shrunken and contracted, dry, brittle and
rusty brown ./
Over anatomical prominences such as cheek,,
chin,costal margins skin becomes stretched
tightly
Mummified tissues are dry, leathery and
brown in colour
The face will be greatly distorted due to
shrinkage of tissues
May be partial starting in certain parts
eg limbs or head.
Later on internal organs dry up, shrink.
Mummified bodies may be destroyed by
insects.
Time for this change 3-12 months.
Favourable factors.
-absence of moisture in air
-continuous action of dry or warm
air.
occurrence
Bodies buried in shallow graves in dry sandy
soils where evaporation of body fluids is very
rapid.
Chronic arsenic & antimony poisoning
Death in deserts.
Newborn babies hidden in kitchen.

Medico-legal importance:Same as in
adipocere

You might also like