At autopsy of a person alleged to have died from torture in custody, which of the following findings would be MOST consistent with previous episodes of blunt injury that were allowed to heal partially before death?
- A Multiple fresh haemorrhages of uniform age with identical histology
- B Single large subdural haematoma with no peripheral bruising
- C Contusions showing different stages of haemorrhage resolution — some red/purple, some yellow-green, at different body sites ✓
- D Petechial haemorrhages limited to the conjunctivae and facial skin
Explanation
In torture victims, repeated episodes of blunt force trauma separated by intervals of days to weeks produce bruises at different stages of resolution. Fresh bruises are red-blue (oxyhaemoglobin); 2–5 days — blue-purple (deoxyhaemoglobin); 5–10 days — green (biliverdin); 10–14+ days — yellow-brown (haemosiderin, bilirubin). Finding bruises of mixed colour ages at multiple anatomically separate sites strongly supports repeated episodes of blunt trauma over time — a pattern inconsistent with accidental injury and consistent with sustained physical abuse or torture. Documentation with photography and histology of biopsy of bruises is recommended.
Reference: The Essentials of Forensic Medicine and Toxicology (Narayan Reddy), 34th ed.
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Written and medically reviewed by the StethoPrep medical team.