Atlas of Forensic Pathology B Suresh Kumar Shetty, Prateek Rastogi, Jagadish Rao Padubidri, Tanuj Kanchan, YP Raghavendra Babu
INDEX
×
Chapter Notes

Save Clear


ThanatologyCHAPTER 1

Thanatology, (from Greek thanatos, “death”) the description or study of death and is concerned with the notion of death as the branch of science that deals with death in all its aspects.
The following changes are seen after death is classified as:
  1. Immediate Changes (Somatic death)
  2. Early Changes (Cellular death)
    1. Skin changes
      The blood circulation to the skin is stopped resulting in pallor and loss of elasticity.
    2. Eye changes
      An early change in eye seen as opacity of cornea and flaccidity of eyeball due to loss of intraocular tension, which progressively comes down to zero in about 2 hours.
    3. Algor mortis (Postmortem cooling)
      Is a progressive loss of heat due to; conduction, convection and radiation after death resulting in cooling of body.
    4. Livor mortis (Postmortem lividity)
      A passive pooling imparts reddish-purple or bluish discoloration of skin in dependent parts of the dead body is called as livor mortis with “contact flattening” on pressure areas of the body.
    5. Rigor mortis (Postmortem rigidity)
      A state of stiffening of muscles after death due to physiochemical process due to ATP is progressively and irreversibly destroyed by dephosphorylating and deamination leading to accumulation of lactates and phosphates in the muscles.
Conditions simulating Rigor Mortis
Heat stiffening: Temperature > 65°C
Cold stiffening: Temperature < 3.5°C
Gas stiffening: After putrefaction sets in.
Cadaveric Spasm/Instantaneous Rigor
In cases of sudden death from excitement, fear, severe pain, exhaustion etc. muscles that were contracted during life become stiff and rigid immediately after death without passing through stage of primary flaccidity due to which exact attitude of person at the time of death is preserved usually limited to single group of muscles frequently involving hands as seen here. This condition is known as Cadaveric Spasm or Instantaneous Rigor or Cataleptic Rigidity of the body.
2
  1. Late Changes (Decomposition)
    1. Putrefaction: Early sign of decomposition is greenish discoloration on right iliac fossa due to hemolysis of red blood cells and the liberated hemoglobin is converted into sulfmethemoglobin by hydrogen sulfide gas may be seen around 12–18 hours after death.
    1. Saponification (Adipocere)
    Modified form of Putrefaction
    1. Mummification
Skeletonization is the removal of tissues from the bones or skeleton, it may be complete; where all soft tissues are removed and partial, where only a few portions of the bones are exposed.
 
 
Artefacts
It may be regarded as any change caused or feature introduced in the natural state of the body that is likely to be misinterpreted at autopsy. These injuries may be produced by aquatic bites, ants and scavengers, etc.
Postmortem artefacts are due to any changes caused or features introduced in a body after death.
It is duty of medicolegal expert to differentiate artefacts from that of injuries thereby preventing false interpretation of finding and misleading of investigation.
 
Types of Artefacts
  1. Resuscitation artefacts
  2. Agonal artefacts
  3. Postmortem artefacts due to:
    1. Improper handling of the body
    2. Postmortem changes
    3. Refrigeration in cold chamber
    4. Decomposition
    5. Animal and insect bites
    6. Autopsy surgeon induced
    7. Embalming
    8. Exhumation.
 
Forensic Entomology (Entomology of Cadaver)
Entomology: Study of insects.
Forensic entomology: Use of insect knowledge in the investigation of crime, used in estimation of time since death or postmortem interval (PMI).
Principle: As the insects arrive on the body soon after death, estimating age of insects can help in estimation of postmortem interval (PMI).
Based on:
  1. Directly from the life cycle
  2. Waves of succession! Time of arrival of different species.
Stages of life cycle
Egg→Larvae→Pupa→Adult
3
zoom view
Figure 1: Tache Noire; an early postmortem change seen in eyes
zoom view
Figure 2: Tache Noire seen in the outer angle of left eye
4
zoom view
Figure 3: Clouding and haziness of cornea seen in both eyes
zoom view
Figure 4: Sunken eyeballs and corneal opacity in both eyes
5
zoom view
Figure 5: Postmortem lividity on the back
zoom view
Figure 6: Postmortem lividity with contact flattening on the back
6
zoom view
Figure 7: Entire body in rigor indicating the posture of the body after death
zoom view
Figure 8: Cadaveric spasm in the upper limbs; driver holding the steering wheel at the time of death
7
zoom view
Figure 9: Instantaneous rigor of hand in a case of drowning
zoom view
Figure 10: Heat stiffening of the body
8
zoom view
Figure 11: Gas stiffening of the body
zoom view
Figure 12: Greenish discoloration on the right iliac fossa and inguinal region
9
zoom view
Figure 13: Greenish dicoloration of abdominal flanks
Marbling of skin in various parts of the body, due to invasion of microorganisms and formation of sulfmethemoglobin and thereby staining the blood vessels and then being prominent giving a marbled appearance to the skin may be seen around 24–36 hours after death (Figs 14 to 19).
zoom view
Figure 14: Marbling seen in right upper arm and right chest wall
10
zoom view
Figure 15: Marbling seen in axilla and right shoulder
zoom view
Figure 16: Marbling seen on upper part of the body
11
zoom view
Figure 17: Marbling seen on left thigh
zoom view
Figure 18: Marbling seen in left upper thigh and groin region
12
zoom view
Figure 19: Marbling seen on the entire back
Autolysis of cells due to hydrolytic enzymes after death is observed as collection of fluids in between dermis and epidermis called postmortem blisters. Loosening of epidermis from the underlying dermis is called skin slippage (Figs 20 to 26).
zoom view
Figure 20: Postmortem blisters seen on left hand and left chest wall
13
zoom view
Figure 21: Postmortem blisters on left thigh and leg
zoom view
Figure 22: Postmortem blister with skin slippage
14
zoom view
Figure 23: Postmortem blisters, skin slippage and erect nipples (gas stiffening)
zoom view
Figure 24: Postmortem blisters and skin slippage seen on the forearm and hand
15
zoom view
Figure 25: Postmortem skin peeling (slippage)
zoom view
Figure 26: Postmortem degloving of palm
16
The putrefactive changes are seen with the advancement of postmortem interval such as; color changes, bloating of face, protrusion of eye and tongue, distention of abdomen, and postmortem purging. In males, scrotal swelling may be observed. During late decomposition process, foul smelling gases are liberated which are collected in the intestine in around 12–18 hours after death (Figs 27 to 37).
zoom view
Figure 27: Bloated face with protruded eyeballs and tongue
zoom view
Figure 28: Bloated face, liquefaction of eyeballs and postmortem purge
17
zoom view
Figure 29: Reddish brown discoloration of the body with disfigured face
zoom view
Figure 30: Gas stiffening and reddish brown discoloration of the body (crime scene)
18
zoom view
Figure 31: Disfigured face with protrusion of the tongue
zoom view
Figure 32: Protruded eyeballs and tongue
19
zoom view
Figure 33: Reddish brown color changes
zoom view
Figure 34: Distended scrotum with reddish brown color changes of the body
20
zoom view
Figure 35: Decomposition showing scrotal swelling and skin slippage over abdomen in infant
zoom view
Figure 36: Protrusion of intestines on opening the abdominal cavity
21
zoom view
Figure 37: Protrusion of intestines on opening the abdominal cavity (autopsy conducted at the crime scene)
zoom view
Figure 38: Loosening of scalp hair after death
22
zoom view
Figure 39: Postmortem prolapse of rectum
zoom view
Figure 40: Intact, discolored and collapsed dura suggestive of underlying liquefied brain
23
zoom view
Figure 41: Liquefied discolored brain on removal of the dura
zoom view
Figure 42: Foamy changes in the liver on cut section
24
zoom view
Figure 43: White clusters of eggs on the skin
zoom view
Figure 44: Clusters of maggots over the body
zoom view
Figure 45: Maggots of varying sizes on the body
25
zoom view
Figure 46: Adipocere formation of the body
zoom view
Figure 47: Adipocere with maggots
zoom view
Figure 48: Adipocere over the abdomen and thigh with maggots
26
zoom view
Figure 49: Partial skeletonization of the body
zoom view
Figure 50: Complete skeletonization of the body
27
zoom view
Figure 51: Artefact caused by aquatic animal
zoom view
Figure 52: Artefacts on the back of hand caused by aquatic animal bites
zoom view
Figure 53: Artefact animal bite on the scrotum
28
zoom view
Figure 54: Postmortem aquatic animal bite and degloving seen in right hand
zoom view
Figure 55: Postmortem rodent bite with nibbled margins
zoom view
Figure 56: Artefact with nibbled margins caused by rodent bite
29
zoom view
Figure 57: Enucleation of right eyeball due to rodent bite with nibbled margins
zoom view
Figure 58: Artefacts around the mouth and forehead
30
zoom view
Figure 59: Artefact of female external genitalia (animal bite)
zoom view
Figure 60: Artefact on the inner aspect of the thigh
31
zoom view
Figure 61: Postmortem loss of foot by aquatic animals (a case of drowning)
zoom view
Figure 62: Postmortem animal bites around the mouth and nostrils
32
zoom view
Figure 63: Mummified body