In the normal sequence of putrefaction in a temperate climate, the first external sign of decomposition is greenish discolouration of the skin. Where does this appear first, and at approximately what postmortem interval?

• A Scrotum in males, 4 to 5 days
• B Left hypochondrium, 2 to 3 days
• C Face and neck, 6 to 12 hours
• D Right iliac fossa, 12 to 18 hours ✓

Explanation

Greenish discolouration begins in the right iliac fossa because the caecum lies close to the abdominal wall there, allowing intestinal bacterial pigments (sulphhaemoglobin) to stain the overlying skin early, classically within 12 to 18 hours. The face and scrotum discolour later, and left-sided abdominal sites are not favoured because the caecal position decides the sequence.

Reference: The Essentials of Forensic Medicine and Toxicology, K S Narayan Reddy, 34th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.