Can a hemorrhage occur after death?
Specifically lung hemorrhages. Can an organ hemorrhage after death and, if so, how long for?
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$\begingroup$ Under certain circumstances, yes. Can you add more detail to clarify exactly what you're looking for? Because the general answer is "no". $\endgroup$– anongoodnurseJul 26, 2017 at 20:51
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$\begingroup$ Hi there, thanks. I'm doing some looking over an autopsy of a celebrity for personal interest as the cause of death is uncertain. The person in question had appeared to have hung themself and CPR had been attempted around 30 minutes after the person had hung themselves. The autopsy later revealed that "the lungs had focci of hemorrhage" and if the hemmorhages were unlikely to have been caused post-death then this makes foul play more likely. $\endgroup$– CharlieJul 26, 2017 at 22:33
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$\begingroup$ To summarise though, the person examined had been dead for a good time when CPR was attempted. $\endgroup$– CharlieJul 26, 2017 at 22:34
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1 Answer
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Usually,blood moves through the body by force from the contraction of ventricles, the contraction on muscles, gravity, or other forces. At death, the only force left is gravity, which is why we see lividity (or livor mortis -pooling of blood in dependent positions) after death. This continues for ~8-12 hours (depending in part on temperature).
The blood in the arterial system at the moment of death is still under pressure because arterial wall musculature has not relaxed yet. (I don't know how long this takes, to be honest.) If an artery is pierced (say, a bronchial artery, e.g. by a knife), blood will flow from a high pressure area to a lower one (e.g. into non-inflated lung tissue, the abdominal cavity, or the outside or the body) So post-mortem hemorrhage can occur until the arterial musculature has completely relaxed. After this relaxation, stabbing a corpse will produce a small amount of oozing at most, unless pressure is applied somehow, e.g. during CPR. CPR may make small petechiae larger.
Livor mortis can occur in the lungs post death as well.
as the blood accumulates in the dependent areas, the pressure of the settling blood can rupture small vesslels, with development of minute hemorrhages (petechiae)... This usually takes 18-24 hours... and is more common in (asphyxia).
Hanging is death by asphyxia, and is known to be associated with lung hemorrhages, but very small ones.
Forensic Pathology, Second Edition By Dominick DiMaio, Vincent J.M. DiMaio, M.D., pp.22-25
answered Jul 27, 2017 at 10:55
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$\begingroup$ Thanks for the great answer! One last thing, as my knowledge of biology is limited, could the "Focci of hemmorrhage" been as a result of CPR (IE pressure on the chest causing lungs to be damaged)? $\endgroup$– CharlieJul 27, 2017 at 14:22
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1$\begingroup$ It's possible but very unlikely. CPR does cause damage: bruised muscle, broken ribs, etc., but it's not common. The petechiae in the lungs after hanging take hours to form as the blood settles in the lower parts of the lung. If the person was only hanging for 30 minutes and CPR was started, the blood is moving, not pooling. Hope that helps. $\endgroup$ Jul 27, 2017 at 17:08
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1$\begingroup$ @Charlie - Here is a list of things CPR can do to screw up autopsy results: Forensic aspects of complications resulting from cardiopulmonary resuscitation. $\endgroup$ Jul 27, 2017 at 17:17
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$\begingroup$ Would it be possible to discuss this further with you in a chat? It would be great to get a knowledgeable person's opinion on the matter and look into more details the autopsy if it would be too much trouble. $\endgroup$– CharlieJul 27, 2017 at 19:32
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$\begingroup$ that is if I can even start a chat, as I'm not entirely sure how to do it without spamming a conversation in chat for ages. $\endgroup$– CharlieJul 27, 2017 at 19:34