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Contusions

Ultrasonography can help characterize bruises and estimate their age more precisely. A study used ultrasonography to examine 10 bruises from autopsies, measuring depth and thickness of subcutaneous hemorrhages. They found ultrasonography provided objective information on bruises that aided in diagnosis of child abuse by complementing visual examination and spectrophotometry. Estimating bruise age precisely can be useful for legal investigations.

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232 views21 pages

Contusions

Ultrasonography can help characterize bruises and estimate their age more precisely. A study used ultrasonography to examine 10 bruises from autopsies, measuring depth and thickness of subcutaneous hemorrhages. They found ultrasonography provided objective information on bruises that aided in diagnosis of child abuse by complementing visual examination and spectrophotometry. Estimating bruise age precisely can be useful for legal investigations.

Uploaded by

Jack
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© © All Rights Reserved
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Contusion/Bruise

 Contusion is an infiltration or extravasion


of blood into the tissue due to rupture of
vessels by the application of blunt force.
 Examples:-Stick,stone or fist.
 Its subcutaneous without discontinuity of
skin.
Features of contusion
 petechies > ecchymoses > haematoma
 Factors modifying size/shape-
 age, sex, site, colour of skin, diseases,
 gravity (ectopic),[1]
 type of weapon(rail/tram line,any pattern),
 time(delayed/come out) ,
 Deep/organ involved

 [1]K.Reddy,the essentials of FM &toxicology,21st edi.,2012,pg170


Age of contusion
. Time colour Due to

Fresh Red Hb

1-3 d Blue Deoxy Hb

4-5 d Brown Hemosiderin

6-7 d Green Hemotoidin

8-12 d Yellow Bilirubin

2 wks Disappear
Antemortem contusion[2]
 Sharp,well defined margins.
 Swelling of the tissues.
 Discoloration of the skin.
 Extravasation of blood into the true skin and
subcutaneous tissue.
 Doubtful cases-Microscopic examination.

 [2]K.Reddy,the essentials of FM &toxicology,21 st edi.,2012,pg172


Postmortem contusion
 Can be produced with in 1-2 hrs after
death.
 If body is decomposed it is difficult to
differentiate between antemortem and
postmortem contusions.
 No signs of vital reaction.
Self inflicted contusion
 Rare-can be inflicted by irritant
substances like Marking nut,root of
plumbago zeyloxica or rosea.(artificial
bruise)
 Can be differentiated by chemical
analysis.
Homicidal contusion
 Shape and size of contusion,indicates the
weapon used.

Accidental contusion
 Their position,arrangement,circumstances
and surroundings.
Medico-Legal Aspects
 Identification of the object.
 Degree of violence.
 Cause of injury.
 Time of injury.
 d/d with lividity
Leg Med (Tokyo). 2012 Jan;14(1):6-10. doi: 10.1016/j.legalmed.2011.09.007.
Epub 2011 Dec 20
Mimasaka Characterization  they used the age of a bruise
S, Oshima of bruises using ultrasonography for can be estimated
T, Ohtani ultrasonography objective examination more precisely using
M for potential of bruises arising from information on the
application in subcutaneous subcutaneous
Cohort diagnosis of hemorrhages, and hemorrhage from
Level 3 child abuse determined whether we ultrasonography in
could precisely addition to
measure the depth and established
thickness of a evaluations by the
subcutaneous naked eye and by
hemorrhage. We spectrophotometry
compared macroscopic
findings, microscopic
findings and
ultrasonographic
images of 10 bruises
in forensic autopsy 
1 A ‘Brush burn’ is
A. An extensive burn
B. A burn produced by electricity
C. Graze abrasion
D. Pressure abrasion
2 Which one of the following is not an
example of pressure abrasion?
A. Ligature mark in hanging
B. Ligature mark in strangulation
C. Teeth bite marks
D. Fingernail marks
3 A blow of moderate violence may
produce a comparatively small bruise, if
the
A. Tissues are loose
B. Tissues are firm and fibrous
C. Tissues are overlying the bones
D. Patient is anaemic
4 The age of the bruise can be determined
by
A. Its size
B. The amount of extravasated blood
C. The changes in the colour
D. All of the above
5 Which one of the following statement is
not correct for an incised wound?
A. The length is more than the width
B. The edges are clean cut
C. Deeper at the beginning
D. Is spindle shaped

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