Late Postmortem changes – Putrefaction

C i.e. Putrefaction

D i.e. Late sign of death

A i.e. Very high temperature

–  In females ovaries & non gravid uterusQ; and in males prostate & testisQ putrify very late only preceeded by skin, muscle, tendon & bone which are last organ to putrify. (in the same order)

– Due to involution of gases, the liver becomes spongy in W. putrefaction and it is k/a Foamy or Swiss cheese or Honey combed liverQ

–  Greenish discolouration of flank over cecum i.e. right iliac fossaQ, which appears in about 12-24 hoursQ (6 hours in summer & > 24 hours in winter) is first external sign of putrefaction (decomposition).

–    In females ovaries & non gravid uterusQ; and in males prostate & testisQ putrify very late only preceeded by skin, niuscle, tendon & bone which are last organ to putrify. (in the same order)

Casper’s dictum relates to the rate of putrefaction of a dead body and helps in estimation of time since death.

Putrefaction is arrested below 0°C & above 48°CQ as the activity of microorganism stops.

Putrefaction is facilitated by free access of air, moisture & optimum temperature (10°C-45⁰C), so decomposition is fast in shallow damp, marshy gravesQ in bodies without clothes & coffin.

C i.e. 2 – 4 days

B i.e. 2-3 days

Ans. Putrefaction

Due to involution of gases, the liver becomes spongy in putrefaction and is called as Foamy/Swiss cheese or Honeycombed liver.  

Ans. Uterus

Ans. Spleen-brain-heart-uterus

Ans. Arsenic

Ans. Rate of putrefaction

Ans. Eight times

Ans. is ‘c’ i.e., Prostate

Order of putrefaction

Order of appearance of putrefaction from earliest to last is :larynx, trachea > stomach, intestine > spleen, liver> brain, lungs > heart > kidney, bladder > uterus/prostate > bone.

Amongst the soft tissues uterus in femaleand prostate in males are last to undergo putrefaction, as uterus and prostate resist putrefaction. Otherwise bones are last to undergo putrefaction, overall

Ans. is ‘c’ i.e., Prostate

Ans. is ‘b’ i.e., Sulph-meth Hb

 Ans:B.)Greenish discoloration over Right iliac fossa.

Greenish dislocation of skin over right iliac fossa is the first sign seen in a decomposed body.

Stages of Decomposition
A.)Fresh (1-2 days)
Autolysis

• This is the part of decomposition that happens almost instanly after death, when the human body starts loosing heat. The body goes through a process called Autolysis/Self-digestion, due to the actions of its own enzymes.

B.)Bloated (2-6 days)
Putrefaction

• Destruction of the soft tissues of the body is caused mainly by the action of bacterial enzymes, mostly anaerobic organisms derived from the intestines. 
• The characteristic features of putrefaction are:

(i) changes in the color of the tissues

• The first external sign of putrefaction in a body lying in air is usually a greenish discoloration of the skin over the region of the cecum, which lies fairly superficially, and where the contents of the bowel are more fluid and full of bacteria.
• Internally, this is seen on the under surface of the liver, where that organ is in contact with the transverse colon.
• The color results from the conversion of hemoglobin of blood into sulphmet hemoglobin by the hydrogen sulphide formed in the large intestine and escaping into the surrounding tissues.
• The green coloration then spreads over the entire abdomen, external genitals and then patches appear successively on the chest, neck, face, arms and legs.
• The patches become dark-green and later purple and dark-blue.
• They are at first scattered, but later on join together and the whole skin of the body appears discolored.
• As a general rule, the organs show putrefactive changes in the following order.
• (1) Larynx and trachea.
• (2) Stomach, intestines and spleen.
• (3) Liver, lungs.
• (4) Brain.
• (5) Heart.
• (6) Kidneys, bladder.
• (7) Prostate, uterus.
• (8) Skin, muscle, tendon.
• (9) Bones.
• (ii) the evolution of gases in the tissues:
• Gas bubbles accumulate in the tissues, causing crepitant, sponge-like feeling which soon begins to distend the body.
• Discolored natural fluids and liquefied tissues are made frothy by gas.
• Due to the presence of gas in the abdomen, the diaphragm is forced upwards compressing the lungs and heart, and bloodstained froth exudes from the mouth and nostrils (postmortem purge), which can be mistaken for the bleeding following antemortem injury.

(iii) the liquefaction of tissues.

• Colliquative putrefaction begins from 5 to 10 days or more after death. The abdomen bursts and the stomach and intestines protrude.

C.)Decay (5-11 days)

• Active decay- this part of decay is reconizeable by a great loss in mass(weight), this weight loss is caused by the ravinous feeding by maggots, and the leaking of the body’s decomposition fluids into the the environment around it

D.)Post-Decay (10-24 days)

• Advanced Decay- this decay is marked by change in the soil surrounding the body that is, by now, leaking fluids. insect activity will start to lessen, and the surrounding plant life will start to die.

E.)Dry Stage (24+ days)

• The final stage of decomposition results in the remains consisting primarily of bones, some dried skin and cartilage. There is typically no odour of decay at this point.
• Skeletonisation- this the final act of human decomposition in a temperate climate it can take two years, in a hot climate it can happen as fast as two weeks, and in a cold temperature it can take longer. all moisture in the body is lost, and the bones are exposed and easily visible.

Ans. is ‘b’ i.e., Lecithinase

Putrefaction

• Produced mainly by the action of bacterial enzymes (lecithinase — Cl. welchii)
• Anaerobic organism (from bowels)
• Causing marked hemolysis and liquefaction in blood vessels and tissue spaces, thus producing following effects

1. Color changes : greenish discoloration in right iliac fossa abdomen —> genitalia -4 chest —> neck —> face – arms -4 legs. Superficial veins over the root of the limbs, thighs, sides of abdomen, shoulder, chest and neck are stained greenish-brown or purplish-red, marbled appearance in 36 to 48 hours (marbling).
2. Foul-smelling and breakdown of proteins and carbohydrates. Gases produced : CO₂ + NH₃ + CH₄ mercaptans + mercaptans (noninflammable) + H₂S (inflammable). Gas bubbles cause crepitation and give spongelike feeling. Blood-stained froth from mouth and nostrils is called postmortem purge.

Distension of body                                       36 to 48 hours

Anus and uterus prolapse                           : 2 to 3 days

PM blisters, face distroted                          : more than 3 days

Nail, skull sutures, and hair loss                 : more than 5 days

• Skin shows slippage, comes off in glove and stocking fashion.
• Postmortem luminescence due to : Photobacterium fischeri bacteria and Armillaria mellea fungi.

      3.Liquefaction of tissues (colliquative putrefaction) : 5 to 10 days.

• Putrefactive effusion : pleural cavity 60 to 100 ml.
• Skeletonization of an uncoffined buried body occurs in about 1 year.
• Order of appearance of putrefaction (earliest to last) : larynx, trachea —> Stomach, intestine —> Liver, spleen —> Brain, lungs —> Heart, kidney -4 Bladder, uterus/prostrate —> Skin,   muscles, tendon -4 lastly, bones.
• Uterus and prostate resist putrefaction (last to putrefy).
• Entomology of the cadaver
• Eggs of houseflies are deposited in 6 to 12 hours in nostrils, mouth, etc.
• In 8 to 12 hours, maggots/larvae are produced from the eggs.
• Maggots become pupae in 4 to 5 days.
• Total time from egg laying to development into adult flies = 8 to 10 days.

Factors causing delay of putrefaction

• Temperature <0°C or > 48° C (very high temperature).
• Dry weather and/or decreased air velocity.
• More than 2 meter deep grave.
• Tight clothing.
• Body in dry soil, and body packed in coffin.
• Infant not fed.
• Wasting diseases like anemia.
• Poisoning : Carbolic acid, ZnC1₂, strychnine (nux vomica), and heavy metals (arsenic, antimony).
• In water slower than in air (casper’s dictum).

Factors facilitating putrefaction

• Putrefaction is facilitated by (i) free access of air (ii) moisture and (iii) optimum warnth (10°C – 45° C). Thus decomposition is fast in shallow damp, marshy shallow graves, in bodies without clothes and coffin.