10/10/2020 P m em Cha ge : O e ie , De ii , Sce e Fi di g

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P e Cha ge
Upda ed: J l 07, 2020
A hor: S Erin Pre nell, MD; Chief Edi or: J Sco Den on, MD more...

OVERVIEW

O e ie
Af er dea h, a eq ence of change na rall occ r in he h man bod . Al ho gh he e change
proceed in a rela i el orderl fa hion, a arie of e ernal fac or and in rin ic charac eri ic ma
accelera e or re ard decompo i ion. [1] Under anding common po mor em change and he ariable
ha affec hem allo he foren ic pa hologi o more acc ra el e ima e he po mor em in er al
(PMI) and o pro ide a ime frame d ring hich dea h occ rred. F r her, an a arene of common
po mor em ar ifac limi he ri k of mi diagno i a he ime of a op .

Hi
Dea h and he change ha follo ha e been ingrained in ocie ince he da n of hi or . Ancien
Eg p ian ook e raordinar mea re o lo decompo i ion, i h ome good re l . La er ocie ie
recogni ed he need o eq e er he dead from he li ing o con ain he pread of di ea e. In modern
ime , berea ed familie m choo e be een crema ion and embalmmen for heir dearl depar ed.
Dea h i a par of life, and decompo i ion i a par of dea h.

E ide i l g

All bodie ndergo ome degree of po mor em change af er dea h. Change begin a he molec lar
le el and eq en iall progre e o micro copic and gro morpholog .

O e ie f he e i
Po mor em change begin oon af er dea h and progre along a imeline. T o proce e ,
p refac ion and a ol i , begin o al er he bod ; ei her one ma predomina e, depending on he
circ m ance rro nding dea h, a ell a he clima e. P refac ion in ol e he ac ion of bac eria
on he i e of he bod . Thi proce , pre alen in moi clima e , i a ocia ed i h green
di colora ion of he bod ; ga prod c ion i h a ocia ed bloa ing; kin lippage; and a fo l odor.

A ol i i he breakdo n of he bod b endogeno b ance . I proceed mo rapidl in organ

ch a he pancrea and omach. I ma predomina e in more arid condi ion and can e en all
re l in m mmifica ion.

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In mo circ m ance , a ol i and p refac ion occ r in andem. In empera e clima ic condi ion ,
he can re l in rapid degrada ion of he i e . The e al era ion ma e en all prod ce grea
di or ion of he bod af er dea h, hampering he in erpre a ion of he po mor em finding b no
ameliora ing he al e of he a op .

Some of he more ell-kno n po mor em change , ch a rigor mor i , li or mor i , and algor
mor i , progre on a rela i el e ched le; ho e er, man e ernal and in rin ic fac or ma affec
heir de elopmen . I ho ld be remembered ha he e ima ed period for he arri al and pa age of
he e manife a ion of he decompo i ion proce i ba ed on die nder er con rolled
condi ion , incl ding a empera e clima e (ie, 75 F). [2]

In reali , man dea h occ r o ide of he e ideal e ing , and addi ional confo nding ariable
ma be pre en (eg, la ered clo hing, obe i , fe er). Effor o impro e he preci ion and reliabili of
e ima ing PMI are ongoing, incl ding he e of ar ificial in elligence in PMI e ima ion. [3, 4] Wilk e al
de cribe a me hod for calc la ing earl PMI ing nonin a i e kin hermome r in conj nc ion i h a
fini e-difference model o correc for non andard condi ion . [5] The longer he PMI, he le acc ra e
he PMI e ima e become .

I dica i f he ced e
Po mor em change ma par iall ob c re an emor em ra ma and di ea e or mimic heir pre ence.
I i e en ial ha he pa hologi recogni e he e finding for ha he are. [1, 6] De pi e he
degrada ion he bod ndergoe d ring he po mor em period, a comple e a op of a decompo ing
bod of en ield ab ndan informa ion.

Al ho gh here i q i e a lo of ariabili in he ime ched le of common po mor em change , all

bodie e en all decompo e o ome degree. The ph ical and biochemical al era ion , hen
con idered in concer i h a horo gh medicolegal dea h in e iga ion, ma allo one o e ima e he
PMI. E ima ion of he ime of dea h i a cri ical componen of foren ic dea h in e iga ion , b i i
ill an imperfec cience. [1, 7] Unle a dea h i i ne ed, i i all po ible o pro ide onl a ime
indo d ring hich dea h co ld ha e occ rred.

Defi i i
Rig i i he po mor em iffening of he bod m cle . I ma or ma no in ol e ome
degree of ac al hor ening of he m cle . In mo ca e , rigor mor i begin i hin 1-2 ho r af er
dea h; i begin o pa af er 24 ho r ( ee he image belo ).

The deceden ho per i en rigor mor i i h he righ arm def ing gra i . The bod m ha e been in ano her po i ion for
e eral ho r af er dea h before being placed in a pine po i ion.
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Li i i he p rple-red colora ion ha appear on dependen por ion of he bod o her han
area e po ed o pre re af er he hear cea e o bea . I re l from he e ling of he blood nder
he force of gra i ( ee he image belo ).

Li or mor i on he po erior a pec of he bod i ca ed b e ling of he blood beca e of gra i hen he bod i in a
pine po i ion.

Ta die are pe echiae and p rp ric hemorrhage ha de elop in area of dependenc

econdar o he r p re of degenera ing e el nder he infl ence of increa ed pre re from
gra i ( ee he follo ing 2 image ).

A he po mor em in er al leng hen , Tardie po de elop in area of li idi , ch a hi indi id al' ho lder area, a
decompo ing capillarie r p re.

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Tardie po on he abdomen.

Alg i i he proce b hich he bod cool af er dea h. Cooling ake place onl if he
ambien empera re i cooler han he bod empera re a he ime of dea h.

Tache i e i he dark, red-bro n ripe ha de elop hori on all acro he e e hen he e elid
are no clo ed af er dea h. I i a dr ing ar ifac ha ma mimic ra ma ( ee he image belo ).

Tache noire de elop hen he e elid are no comple el h and po mor em dr ing occ r .

P ge fl id i decompo i ion fl id ha ma e de from he oral and na al pa age a ell a o her

bod ca i ie ( ee he image belo ).

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Po mor em p rge fl id e de from he oral and na al pa age ; no ra ma ic inj rie ere nco ered a a op .

Dec i i i he po mor em proce of endogeno a ol i and p refac ion from e ernal

and primaril in ernal bac erial o rce ( ee he image belo ).

Decompo i ion i a proce of a ol i and p refac ion.

Mace a i i an a ol ic po mor em proce ha occ r in in ra erine dea h . I i ca ed b

endogeno en me ; p refac i e bac eria are no a fac or ( ee he image belo ).

Macera ion af er re en ion of an in ra erine fe al dea h.

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P e i e al i he ime ince dea h.

Sce e Fi di g
Finding a a cene are e raordinaril helpf l in he a e men of po mor em change . The
en ironmen , in par ic lar he empera re, infl ence he ra e of decompo i ion; higher empera re
ha en he proce . I ho ld be remembered ha here ma be a arie of microclima e i hin he
ame locale ha can infl ence po mor em change (eg, he bod ma ha e lain belo an air
condi ioning en ). When e ima ing he ime of dea h, he gro finding m be correla ed i h he
pre ailing en ironmen al fac or . The infl ence of local fa na m al o be con idered. The pre ence
of in ec or ign of animal ac i i near he bod ma be correla ed i h i e defec re l ing from
po mor em carni oro feeding.

Rigor mor i ma de elop er rapidl if he bod i acido ic a he ime of dea h. Sign of a r ggle
ma e plain accelera ed rigor mor i beca e rigor mor i i rela ed o a drop in pH i hin m oc e . In
ome ca e , rigor mor i or li or mor i ma appear in pa ern incon i en i h he effec of gra i a
he cene. Thi indica e ha he bod a mo ed (ei her b earl re ponder or omeone el e)
before he in e iga or a e ed he bod . I ma indica e ha he bod ha been ran por ed from
ano her crime cene.

Circ m an ial ime marker ma a i in narro ing he po mor em in er al. For e ample, he da e of
he olde ne paper on he fron door ep ma indica e ha he deceden died before he deli er of
ha ne paper (pro ided he per on reg larl picked p he ne paper). A per on fo nd dead
earing pajama in he ki chen i h a bo l of cereal on he able gge ha dea h occ rred in he
morning. An a oma ed eller machine (ATM) receip fo nd in he clo hing of a decompo ing bod
gge o in e iga or ha he deceden a ali e a he ime and da e ha appear on he receip .
Similarl , he ime and da e ha a final email or e me age a en ma be helpf l in a i ing in
he e ima ion of he PMI.

T ace E ide ce
Ad anced po mor em change ma ob c re or de ro ome race e idence. Hair and fiber ma
be lo a he pper la er of kin lo gh. The pre ence of oo or ippling aro nd a g n ho o nd
ma al o be diffic l o a e on lo ghed, di colored kin. D ring he earl PMI, ho e er, al able
race e idence ma per i , incl ding he pre ence of perm and pro a ic acid pho pha a e in e al
a a l ca e , al ho gh ch e idence doe degrade i h ime. [8]

G E a i ai a d Fi di g
Rig i de elop a he bod energ o rce (adeno ine ripho pha e [ATP]) i deple ed.
M cle fiber req ire ATP for rela a ion; once deple ed, ac in and m o in pro ein remain comple ed,
re l ing in iffening of he m cle . Rigor mor i i ho gh o de elop in all m cle im l aneo l ;
ho e er, i i mo e iden fir in he maller m cle gro p , ch a he ja , af er hich rigor mor i
picall occ r in he pper e remi ie and hen he lo er e remi ie , a in he follo ing image.

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The deceden ho per i en rigor mor i i h he righ arm def ing gra i . The bod m ha e been in ano her po i ion for
e eral ho r af er dea h before being placed in a pine po i ion.

Rigor affec bo h moo h and kele al m cle , incl ding he m ocardi m ( im la ing h per roph ),
hair follicle (re l ing in c aneo "goo e b mp ") ( ee he image belo ), and eminal e icle
(re l ing in po mor em emen relea e from he penile mea ).

Rigor mor i of he erec or pilae can re l in po mor em "goo e fle h."

Rigor mor i fir appear appro ima el 1-2 ho r af er dea h. Progre i e iffening occ r for
appro ima el 12 ho r , per i for appro ima el 12 ho r , hen dimini he o er he ne 12 ho r
a i e break do n a a re l of a ol i and p refac ion.

Rigor mor i ma be ed o ded ce he po i ion of he deceden if he bod ha been mo ed af er he

de elopmen of rigor mor i . If rigor mor i i broken b manip la ion before becoming f ll fi ed, i
ma reform in he ne po i ion.

The e ima ion of he reng h of rigor mor i i of en ra ed on a cale of 0 4 and i highl bjec i e.

Cada eric pa m i an ncommon and di p ed form of rigor ha de elop immedia el pon dea h,
all af er ren o ac i i . One heore ical e ample o ld be a dro ning ic im hand cl ched
aro nd a a ch of gra gro ing on he a er edge. In ch ca e , i i pre med ha he
deceden a in profo nd lac ic acido i a he ime of dea h a a re l of iolen r ggle and en
in o rigor mor i immedia el .

Li i all appear 30 min e o 2 ho r af er dea h, ho gh i ma appear ooner in ca e

of e ere hear fail re in hich he an emor em circ la ion a l ggi h. Af er a PMI of 8 12 ho r ,
red cell e ra a a e from he e el in o he rro nding of i e. Un il ha ime, he applica ion
of pre re o an area of li or ill re l in blanching of he kin (a depic ed in he image belo ).

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Pre re on nfi ed li or re l in blanching of he colora ion.

Af er ha period, li or ma blanch i h forcef l pre re b ill e en all no blanch, a hich ime i

i con idered fi ed. Mo emen of a bod before he comple e fi a ion of li or ill re l in he
redi rib ion of li idi in o he ne l dependen area of he bod . If here i par ial fi a ion of he li or
a he ime he bod i mo ed, i i o be e pec ed ha he original pa ern of di rib ion of re id al
li or o ld remain, a ho n in he follo ing image.

Li or mor i in an an erior po i ion. The area of blanching acro he che and abdomen re l ed from he deceden l ing on
op of hi lef arm and righ hand.

Li or mor i al o affec he organ ; i i of en mo apprecia ed in he l ng , hich appear conge ed

in dependen area ( ee he follo ing image). In appearance, li or ma differ markedl from ca e o
ca e. I ma be diffic l o di cern li idi in darkl pigmen ed indi id al and in ca e in hich near
e ang ina ion ha occ rred.

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The l ng i dark p rple in he po erior dependen area a a re l of li or mor i . Thi ma im la e conge ion.

Li or ha become par ic larl impor an in de ermining he po mor em po i ion of infan (eg, prone
leeping po i ion) hen fir re ponder ha e mo ed he deceden before he arri al of agenc
in e iga or . A breakdo n of i e , incl ding he a c la re, progre e , red cell e ra a a ion
in o he of i e ma ac all im la e an emor em hemorrhage, a demon ra ed in he image
belo . Differen ia ion i made in he con e of he loca ion and pa ern of he di colora ion and he
e en rro nding he dea h. In ome ca e , i ma no be po ible o differen ia e an emor em
ra ma from po mor em ar ifac al effec .

Decompo i ion ha progre ed in hi indi id al i h breakdo n of blood e el and e ra a a ion of red blood cell in o he
bc aneo and adipo e i e of he abdomen, im la ing an emor em hemorrhage. There ere no a ocia ed
c aneo or bon inj rie , and he cene a innoc o .

Ta die de elop in area of dependenc , hence, in area of li or. The occ r econdar o he
r p re of e el nder he infl ence of increa ed pre re from gra i in conj nc ion i h a c lar
breakdo n ( ee he follo ing 2 image ). Cla icall , he are een in ca e in ol ing hanging ; he
appear on he lo er leg of indi id al ho ha e been f ll pended, al ho gh he ma be een in
an area of dependenc .

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A he po mor em in er al leng hen , Tardie po de elop in area of li idi , ch a hi indi id al' ho lder area, a
decompo ing capillarie r p re.

Tardie po on he abdomen.

Tardie po ma be conf ed i h premor em pe echiae or p rp ric hemorrhage . An analogo

proce ma occ r in he conj nc i a and clera, a i ome ime een in ca e in hich a per on
die in a po i ion in hich he head hang do n ard off of a bed. In he e ca e , he conj nc i a and
clera are injec ed, and hemorrhage ma become confl en ; ne er hele , a en ion ho ld ill be
paid o an emor em ca e of oc lar hemorrhage .

Alg i i he proce b hich he bod cool a hea prod c ion cea e and bod hea i lo
o he en ironmen . Bodie in hich he ra io of he rface area o bod ma i large cool more
q ickl (eg, bodie of hin people and infan cool more q ickl han bodie of obe e per on ).

There are e eral form la for e ima ing he ra e of po mor em cooling; ho e er, i h all he e
form la , i i a med ha dea h occ r in empera e condi ion and ha he deceden had normal
an emor em bod empera re (ie, he an eceden bod empera re ac all arie from 93.74
100.04 F, a de ermined rec all ). [9]

The e form la end o gi e a en e of cien ific acc rac o he e amina ion and can be mi leading.
A general r le of h mb i ha he bod lo e hea a an a erage of 1.5 -2 F d ring he fir 12 ho r
af er dea h. [10] Ho e er, he ra e of cooling i drama icall affec ed b he circ m ance of dea h,
mo ignifican l , b he en ironmen al and bod empera re . A bod ill onl cool o he
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en ironmen al empera re; a bod l ing in 105 F d ring he mmer o ld no be e pec ed o cool
a all in fac , in ch circ m ance , he bod empera re o ld increa e.

O her ignifican fac or affec ing algor mor i incl de he bod loca ion (eg, hade er n),
clo hing, and he habi of he deceden . A cold ile floor o ld promo e bod cooling a a re l of
cond c ion. Obe e indi id al and hea il clo hed indi id al o ld be e pec ed o lo e hea more
lo l .

P ge fl id i fo l melling, red-bro n fl id ha ma e de from he oral and na al pa age a

decompo i ion progre e , a depic ed in he image belo . I of en flo af er pre re i e er ed on
he bod , ei her from he pre ence of ga e ha re l from in ernal decompo i ion or follo ing
manip la ion of he bod . P rge fl id ma im la e an emor em hemorrhage, b no ra ma ic inj rie
ill be de ec ed a a op .

Po mor em p rge fl id e de from he oral and na al pa age ; no ra ma ic inj rie ere nco ered a a op .

Tache i e i hori on al darkening of he e po ed clera ha occ r econdar o dr ing hen he

e elid are lef par iall opened af er dea h. The charac eri ic loca ion along he par ed e elid i
in r men al in in erpre ing hi finding ( ee he image belo ).

Tache noire de elop hen he e elid are no comple el h and po mor em dr ing occ r .

O her m c membrane , ch a he lip and ong e, ma al o darken and appear hemorrhagic

hen dried. Inci ion in o he nderl ing i e ill re eal no hemorrhage ( ee he follo ing image).

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Po mor em dr ing of he ong e and m co al membrane darken he i e , impar ing a p e dohemorrhagic appearance.

Ga ic e i g refer o he proce of dige ion af er con mp ion of a meal. Depending on he

i e and compo i ion of he meal, emp ing of he omach ma occ r o er a period of o 6 ho r
or, in ome ca e , m ch longer. S re ma dela normal dige ion. The pre ence of omach
con en ma be mo helpf l if he con en are recogni able and if i i kno n hen he deceden
con med ha par ic lar meal. I i no a reliable indica or of he PMI.

Dec i i i a proce of endogeno a ol i and p refac ion, primaril from in e inal

microorgani m . The bac erial flora di emina e , o ing o he fac ha he bod no longer ha a
f nc ional imm ne em. The abdomen de elop a green di colora ion af er 24 36 ho r , all in
he righ lo er q adran fir ( he loca ion of he microbe-laden cec m). An e ample of hi i belo .

Earl decompo i ional change are manife ed b green di colora ion o er he abdomen.

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Marbling ma de elop i h he delinea ion of he a c la re a a re l of he reac ion of h drogen

lfide prod ced b bac eria i h hemoglobin from he l i of er hroc e , a ho n belo . Bloa ing
of he bod occ r a a re l of bac erial ga prod c ion; in in empera e condi ion , bloa ing occ r
o er a period of 2 3 da . Bloa ing ca e di or ion of bo h he bod and face.

Marbling o line he a c la re in hi deceden a he po mor em in er al leng hen .

Ga (eg, h drogen lfide, me hane) form in he organ and bc aneo i e a ell a he

bod ca i ie . Epidermal e icle forma ion and kin lippage occ r a he epidermi epara e from
he nderl ing dermi . The bod become diff el di colored green-black, of en ob c ring he race of
he deceden ( ee he follo ing image).

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Decompo i ion ad ance i h green di colora ion of he kin, generali ed bloa ing (beginning in he abdomen), and e icle
forma ion i h b eq en kin lippage.

Deglo ing of he kin of he palm and ole picall occ r d ring decompo i ion, a ell a in ca e
in ol ing hermal e po re (ie, fire ) and immer ion ( ee he image belo ).

Po mor em deglo ing of he hand.

The epidermi commonl re ain eno gh ridge de ail o allo fingerprin o be ob ained, hich a i
in he iden ifica ion of he deceden , a demon ra ed belo .

A la enforcemen official ili e he deglo ed finger o ob ain fingerprin .

In ernall , organ di in egra e a differen ra e . The pancrea , adrenal gland , and ga roin e inal
m co a ho marked a ol i earl in he PMI ( ee he follo ing image ). Indeed, i h i dige i e
en me , he pancrea ma ho earl breakdo n of i a c la re; o he ine perienced e aminer,
eepage of red blood cell ma mimic hemorrhagic pancrea i i .

Vie of collap ed, decompo ing organ in he che ca i i h maggo pre en and ga eo di en ion of he in e ine .

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The er and pro a e re i decompo i ion he longe , o ing o he amo n of fibrom c lar i e
in he e organ .

The brain rn a pink-gra color and ndergoe liq efac ion o er a period of eek . Fa ma al o
liq ef , a een in he follo ing image. Small, hi e calci m oap gran le ma de elop on he
epicardial and endocardial rface of he hear , and he in ima of he a c la re rn a d k
p rple a a re l of red cell hemol i .

Liq efied fa draining in o he che ca i .

O her po en ial ar ifac of decompo i ion im la ing an emor em illne or ra ma incl de r p re of

he omach or e ophag , "hemorrhage" in he po erior neck an erior o he er ebrae, and
e ra a a ion of blood in o he of i e in area of dependen li idi .

Fac or accelera ing decompo i ion incl de ep i , hea (ie, en ironmen al hea and bod
empera re), and proce e ha promo e hea re en ion. Of no e, bodie bmerged in a er
decompo e a a lo er ra e han ho e on land ha are e po ed o air. Bodie b ried in he gro nd
ha e he lo e ra e of decompo i ion, o ing o he picall cooler empera re ndergro nd and
he rela i e inacce ibili of he bod o en ironmen al preda or .

T o le common arian of decompo i ion are ifica i a d adi ce e f a i . The

former proce occ r in arm, dr en ironmen here he i e rapidl de icca e and re i he
pical " e " decompo i ion. Wi h m mmifica ion of he bod , e ernal inj rie ma be pre er ed,
ho gh he i e of o nd ma be di or ed, a demon ra ed belo .

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M mmifica ion of hi homicide ic im occ rred af er he remained in a ec re bedroom in A g in he o hea ern Uni ed
S a e for almo 2 eek i h no air condi ioner. M mmifica ion pre er ed he n mero ab o nd and inci ed o nd ,
allo ing acc ra e po mor em a e men of her inj rie .

Adipocere forma ion picall occ r in bodie bmerged in a er or in arm, h mid en ironmen .
The i e are con er ed in o a a , pa ma erial a a re l of he reac ion of clo ridial en me
ih i e fa acid , a een in he follo ing image.

Adipocere ha de eloped in hi per on ho a ealed in a barrel con aining a er and b ried for o er 5 ear .

Organ con er ed in o adipocere re i degrada ion and are freq en l pre en for po mor em
e amina ion ( ee he image belo ); ho e er, he i e are e remel friable and ill of en cr mble
pon manip la ion.

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Al ho gh a , he in ernal organ re i p refac ion hen con er ed o adipocere.

I i no ncommon for m mmifica ion and adipocere forma ion o affec locali ed area of he bod
ha o ld o her i e ndergo he al decompo i ional change (eg, m mmifica ion of he finger
and oe i commonplace). An e ample of hi i belo .

I ola ed m mmifica ion ma be e iden in area of he bod i h le i e ma , ch a he no e, ear , hand , and fee .

A drama ic componen of he pec r m of po mor em change re l from e po re of he bod o

in ec ac i i . In Nor h America, he depo i ion of fl egg on h man remain and he en ing maggo
ac i i can be raced o he blo fl , a een belo .

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The deceden demon ra e almo comple e kele oni a ion of he head a a re l of maggo ac i i .

The defec ca ed in h man i e b in ec lar ae (eg, maggo ) ma mimic r e inj r .

Addi ionall , he blood and e po ed i e in an emor em o nd a rac in ec , ho e ac i i ie
di or an emor em le ion and, in ome ca e , ob c re heir charac eri ic or pre ence. Blo flie
all la egg in empera re higher han 50 F in da ligh ho r i hin ho r of dea h hen he
ha e acce o bodie ( ee he follo ing image).

Fl egg , hich re emble Parme an chee e, acc m la e on moi area and acce ible orifice of he bod .

The egg ha ch in 1 2 da . The lar ae (ie, maggo ) con me i e and gro hro gh 3 lar al
age , kno n a in ar , a demon ra ed in he image belo .

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Yo ng maggo re emble fl egg b are mobile. In hi ca e, fl egg ere laid in he moi en ironmen of he par iall
open e e , nare , and mo h. The egg ha ched and migra ed acro he face.

The pro eol ic en me ecre ed b large n mber of maggo ork o increa e he ra e of i e

breakdo n. The lar ae p pa e in appro ima el 1-2 eek ; ad l flie emerge in ano her 2 eek , a
een in he follo ing 2 image . The e imeline , ho e er, ar grea l i h he pecie and
en ironmen al fac or ; in ome ca e , a foren ic en omologi ma need o be con l ed o a i in
e ima ing he PMI. [11, 12]

Fl p pae ch a he e are of en reco ered a a from he bod , beca e maggo migra e before p pa ion; he e ho ld be
reco ered from he dea h cene if he ime of dea h i in q e ion.

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Fl p pae on a deceden ; no e he pre ence of o her in ec .

In ec preda ion b roache and an ma occ r a an age d ring he PMI. The picall prod ce
ello -red, irreg lar abra ion , hich all ma be recogni ed b heir gro ped pa ern on he bod
( ee he image belo ). An hem el e ma con me fl lar ae and lo he ra e of decompo i ion.
[13]

Po mor em an and roach ac i i lea e a pical gro ped pa ern of po mor em "abra ion ."

Carni ore ch a roden , ca , dog , and l re ma fea on a bod . Roden ac i i i pified

b a ello -ba ed defec , of en i h calloped edge ( ee he image belo ).

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Thi indi id al a reco ered in a home i h ra . Po mor em bi e mark are ello , bloodle defec i h calloped edge .
Top: Third me acarpal and pro imal phalan . Bo om: Fif h me acarpal and pro imal phalan .

Canine ac i i al o re l in ello defec ; gna mark ma be apparen on he nderl ing bone ,

a ho n belo .

Po mor em gna mark on a long bone.

V l re crea e c aneo defec and ma con me in ernal organ hro gh rpri ingl mall
opening in he kin. Beak mark ma be e iden aro nd he c aneo defec , a demon ra ed
belo ).

Po mor em l re ac i i on he leg of a oman reco ered in a ooded area; he nderl ing endon i e po ed, and m ch
of he m c la re i ab en . Irreg lar, ello defec aro nd he deeper o nd are con i en i h beak mark .

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Bodie reco ered from open a er commonl demon ra e he feeding ac i i of marine life (eg, fi h,
crab , hrimp) on he fle h par of he bod ch a he lip , e elid , and ear ( ee he e ample
belo ).

Po mor em i e con mp ion ca ed b mall marine animal ch a fi h and crab on he dor al hand. The edge of he
defec are picall calloped.

Larger marine life ch a alliga or and hark ma prod ce defec ha mimic an emor em harp
and bl n force inj rie , a demon ra ed in he follo ing image. Al ho gh he e po mor em defec
are picall ello , blood eepage in o he e area ma ca e he e defec o re emble an emor em
ra ma. Con er el , a er ma a h clean an emor em of - i e hemorrhage, ca ing a r e inj r
o re emble an ar ifac .

Larger marine life ch a hark and alliga or ma con me large amo n of i e and lea e harp inj rie in he of
i e and/or bone. In ch ca e , i ma be diffic l o de ermine he her he inj rie repre en an emor em ra ma or
po mor em ar ifac .

Skele i ai all req ire mon h o occ r in empera e condi ion , b i ma de elop in le
ime if larger preda or ha e acce o he bod ( ee he follo ing image). Larger preda or ma
remo e bod par and crea e po mor em ar ifac , ch a gna mark on bone . The applica ion of
an hropologic die i helpf l in a e ing he deceden gender, race, i e, and age. Unle

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an emor em inj rie affec he bon r c re , e idence of he ca e of dea h in ome ca e ma be

comple el lo a a re l of kele oni a ion and he lo of of i e.

Thi kele on i ha of an ad l man ho had been mi ing for 1.5 mon h d ring he la e fall in he o hea ern Uni ed
S a e . He a fo nd in a ooded area. Al ho gh he kele on a mo l in ac , gna mark ere e iden on e eral rib .

Mace a i i a proce ha occ r in ca e of in ra erine demi e, a ho n in he follo ing image.

I i an a ol ic proce no iceable e eral da af er an in ra erine dea h ca ed b endogeno
fe al en me ; beca e he fe i picall erile, p refac i e bac eria all do no pla a role.
E cep ion incl de ca e in hich he fe had an infec ion, ch a chorioamnioni i or congeni al
pne monia; in ch ca e , he fe ma ho more charac eri ic ign of decompo i ion.

Macera ion af er re en ion of an in ra erine fe al dea h.

T picall , he macera ed fe ho dark pink o bro n di colora ion of he kin, follo ed b kin
lippage i ho ga eo bloa ing. A macera ion progre e in ero, join loo en and he k ll
pla e epara e; charac eri icall , he k ll pla e o erride heir re , hich o he ine perienced
e aminer ma mimic head ra ma. Once e pelled from he er , he fe or infan ma become
coloni ed b en ironmen al bac eria, adding a p refac i e componen o b eq en po mor em
change .

The pre ence of macera ion ma be ed a proof of an in ra erine fe al dea h. The ab ence of
macera ion, ho e er, doe no e cl de an in ra erine dea h, beca e i ake ome ime o de elop.
[14] Ano her proce ha commonl occ r in ca e of infan mor ali i he po mor em
bc aneo congealing of fa af er he bod i refrigera ed; he re l an do gh con i enc of he
i e ma im la e a liga re mark aro nd he neck, a ho n belo ).

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Congealing of bc aneo adipo e i e on he neck of an infan ma mimic ra ma.

E bal i g, hich in ol e he admini ra ion of fi a i e fl id and/or po der in o he bod , lo

he proce of decompo i ion drama icall . Ho e er, embalming in rod ce i o n ar ifac , incl ding
c aneo inci ion o gain a c lar acce , picall on he la eral neck and/or groin, and rochar
defec on he abdomen i h a ocia ed in ernal organ di r p ion. An e ample i ho n belo . The
i ceral defec are charac eri ed b he ab ence of hemorrhage and he ab ence of hi ologic
reac i e change .

Trochar hole in an embalmed deceden (b on remo ed).

Wiring of he ja ma hamper oral e amina ion. Cap o er he e e globe m be remo ed o

a e oc lar finding . Co me ic cream ed on he kin ma ob c re an emor em inj rie .
Embalmed bodie ha ha e been b ried and b eq en l e h med commonl ho c aneo
f ngal gro h, e peciall in e en ironmen , a depic ed in he follo ing image. Wi h he pa age of
ime, adipocere ma de elop.

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F ngal gro h on a pre io l embalmed and b eq en l e h med bod .

S ecial di ec i

Decompo i ion doe no precl de he po ibili of performing a comple e a op . Ti e ch a

li er, pleen, kele al m cle, kidne , and brain ma be ed for o icologic anal i if blood i no
a ailable. Long bone egmen , incl ding he marro pace, ee h, and kele al m cle, are ef l for
DNA anal i .

S ecial a ced e

Imaging studies

I i ad i able o ob ain radiograph of bod region in a decompo ing bod hen po en ial ra ma
canno be a e ed. The e all incl de area in hich i e a lo a a re l of in ec or
animal ac i i . Imaging die allo he pa hologi o find projec ile or radiopaq e fragmen in he
bod in ca e in hich he deceden ained a g n ho o nd or a a a l ed i h a me allic
objec (eg, a knife). Ho e er, he ab ence of radiopaq e fragmen doe no e cl de he po ibili of
an a a l .

Radiograph are al o ef l in he iden ifica ion of decompo ed remain (eg, facial in

config ra ion, or hopedic hard are). Po mor em comp ed omograph (CT) can can be ef l in
doc men ing inj rie and di ea e in decompo ed bodie . The are par ic larl ef l in iden if ing
in racranial pa holog before remo al of he crani m.

Addi ionall , CT canning can be ed in a ra ma ic dea h ; caref l in erpre a ion i req ired o
differen ia e normal po mor em change from pa hologic le ion a one can mimic he o her. [6]

Insect collection

I i e remel helpf l o in ol e an en omologi in ca e in ol ing in ec ac i i ; en omologi can

pro ide informa ion a o he pe of in ec ( ) and he age of he in ec life c cle a he ime of
di co er . The elec ion, handling, and orage of he in ec pre en on and aro nd he bod m be
properl carried o for da a o be ef l. In ec a all age of de elopmen pre en a he ime of
di co er of he bod ho ld be killed and pre er ed; ome ho ld al o be re ained ali e i h a food
o rce for b eq en e al a ion. Al o, he charac eri ic of he en ironmen in hich he deceden
a fo nd m be doc men ed and he ambien empera re recorded o a i in predic ing he
in ec ma ra ion ra e in ho e par ic lar circ m ance .

S ecial ha dli g

S andard preca ion ho ld be ili ed hen performing an a op of an indi id al, regardle of

he e en of decompo i ion. In all ca e , i i i e o en re proper a op room en ila ion. The
pa hologi ho ld proceed i h ome degree of care d ring he a op of a decompo ing indi id al
beca e i e become more delica e a he PMI progre e . Indeed, i i no n al for he brain
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o be in ac a he ime he cal ari m i remo ed and o hen di in egra e comple el a a re l of

di r p ion of he arachnoid membrane ppor ing he liq ef ing parench ma hen an a emp i made
o remo e he brain.

Hi l g a d Mic c ic E a i a i a d Fi di g
Hi olog ma a i in di crimina ing a po mor em ar ifac from an an emor em inj r b
doc men ing he pre ence or ab ence of an inflamma or re pon e. [15] Ho e er, in ignifican l
decompo ing i e , hi olog re eal e en i e a ol i and bac erial o ergro h, hich hamper
hi opa hologic in erpre a ion of bo h di ea e and ra ma. In ome ca e , a richrome ain ma be
ef l in confirming m ocardial fibro i or cirrho i .

Ph g a h a dD c e ai
A in all foren ic ca e , pho ograph of he deceden aken a he cene doc men ing he po i ion of
he bod hen di co ered ( hen po ible) are al able adj an o he in erpre a ion of he
po mor em finding and change . Pho ograph of all per inen po i i e and nega i e finding ma
addre q e ion ha ari e a he ca e nfold . Pho ograph and diagram pplemen he ri en
de crip ion con ained in he final a op repor .

A cilla a d Adj c i e S die

Vi reo fl id, if a ailable, ma be e al a ed for he pre ence of e eral anal e , incl ding odi m,
po a i m, chloride, rea ni rogen, crea inine, gl co e, and ke one /ace one. Immedia el af er dea h,
i reo anal e le el reflec erminal an emor em er m concen ra ion be er han po mor em
blood ample do, o ing o he fac ha i reo fl id i con ained i hin he e e and i par iall
pro ec ed from he b prod c of cell lar a ol i . Urea ni rogen and crea inine le el ho he mo
po mor em abili ; odi m and chloride le el are rela i el able o er he earl PMI b decline a
decompo i ion progre e . T picall , markedl decrea ed le el of odi m and chloride and a
markedl increa ed po a i m le el are reflec i e of decompo i ion.

The gl co e le el decline rapidl d ring he PMI; a concen ra ion of ero i no n al in a heal h

indi id al ho cc mbed o ra ma ic inj rie . Ho e er, high le el ma reflec a diabe ic a e. The
pre ence of ace one and/or ke one in he oc lar fl id b an ia e a diagno i of diabe ic
ke oacido i in ca e in hich he gl co e le el i ele a ed. In he ab ence of a high gl co e
concen ra ion, heir pre ence ma indica e ar a ion. [16]

Vi reo fl id po a i m le el ha e been ho n o eadil increa e af er dea h; he i reo fl id

po a i m le el ma be ed o help e ima e a PMI in empera e condi ion . Ho e er, he e i ing
form la are re ric ed b confidence limi of almo +/- 1 da ; all are be ili ed in he fir 100
ho r from he ime of dea h. N mero o her ariable affec he i reo po a i m le el, incl ding
an emor em er m le el and he aforemen ioned condi ion promo ing accelera ed decompo i ion. In
empera e condi ion , i reo fl id i picall no re rie able af er appro ima el 4 da .

Vi reo fl id concen ra ion of ome compo nd , incl ding alcohol and ome medica ion , are
reflec i e of er m le el 1 2 ho r before dea h. Compari on of i reo fl id concen ra ion ih
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er m le el ma be of al e in a i ing he de ermina ion of he manner of dea h in o erdo e ca e .

[2] Fore ample, ignifican l higher dr g concen ra ion in he po mor em blood, a compared i h
he dr g concen ra ion in i reo fl id, gge an ac e o erdo e (po ibl icide) ra her han
chronic o ercon mp ion of he medica ion ( hich o ld likel be acciden al). I ho ld al o be
remembered ha p refac ion ma re l in e hanol forma ion in he i e and blood a he PMI
leng hen . Le el a high a 0.1 g/dL are readil enco n ered. Some o rce a e ha le el ma be
a high a 0.2 g/dL.

C Mi c ce i
One of he mo common mi concep ion in foren ic pa holog concern he abili o pecif an e ac
ime of dea h. There ha e been n mero ca e in hich po mor em change aken o of con e
confo nded PMI e ima e . More han an hing, en ironmen al condi ion al er he decompo i ion
proce . One deceden ho a pre er ed in a che free er for 1 ear ho ed minimal ign of
decompo i ion. Ano her indi id al fo nd in a field in he o hea ern Uni ed S a e d ring mmer
ho ed ad anced decompo i ion, e all in e iga i e informa ion, incl ding a receip on hi
po e ion, indica ed ha he died i hin 24 ho r of la being een ali e. In erpre a ion of ph ical,
micro copic, and biochemical po mor em change i ho correla ion i h he circ m ance of
dea h ma re l in ignifican l erroneo PMI e ima e .

O her mi concep ion re ol e aro nd he pre med abili of he foren ic pa hologi o defini i el
differen ia e be een an emor em inj rie and po mor em change in a bod ho ing ignifican
decompo i ion. Depending on he degree of decompo i ion and charac er of he po mor em ar ifac ,
ch differen ia ion ma no be po ible. Wo nd inflic ed immedia el before or immedia el af er
dea h ( he "perimor em" in er al) are par ic larl problema ic.

Ano her common m h in ol e lo of bo el and bladder con rol a he ime of dea h. Al ho gh hi

ma occ r, i i in no a a ni er al phenomenon. In mo ca e , rine can be reco ered from he
bladder a he ime of a op and he rec m of en con ain fecal ma erial.

Perhap he grea e mi concep ion re ol e aro nd he ili and ef lne of performing an

a op on a decompo ed bod . A a general r le, informa ion can be ob ained from e er a op ,
ho gh p refac ion, kele oni a ion, or preda ion ma limi he abili of he pa hologi o dra
defini i e concl ion .

I e A i i gi C
I e ari ing in co r concerning po mor em change ma cen er aro nd po mor em ar ifac being
in erpre ed a re l ing from an emor em di ea e or ra ma. Indeed, one d re ealed ha a
n mber of ca e ere referred for foren ic a op from la coroner on he ba i of mi in erpre a ion
of common po mor em ar ifac a an emor em inj rie . The e change incl ded p rging of fl id,
deep bl i h li idi , dr ing of he kin, bloa ing, and kin lippage. [17]

PMI e ima e are of en cr ini ed in he co r room and ma affec he eraci of a defendan alibi.
In egra ion of all gro , biochemical, en ironmen al, circ m an ial, and adj nc i e informa ion i
req ired before de ermining a ime frame ha incl de he PMI.

Clo e
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Wha ld like i ?

Wha ld like i ?

Prin hi ec ion: Defini ion

Prin he en ire con en of Po mor em Change
Prin he en ire con en of ar icle

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