JOURNAL READING

An Autopsy Study to Evaluate Time Since Death from

Organs Weight and Physical Parameters

Penguji:
dr. Arif Rahman Sadad, SH, SpF, Msi.Med,DHM

Residen Pembimbing:
dr. Raja Al Fath, MH
KEPANITERAAN KLINIK SENIOR BAGIAN ILMU KEDOKTERAN FORENSIK DAN MEDIKOLEGAL
FAKULTAS KEDOKTERAN UNIVERSITAS DIPONEGORO
2017
Presented by :
Yunanda Rizki Amalia
Intan Pratama N P
Amalia Siti
Gianita P D
Ragil Prasmadhan
Fatihatul Firdaus
JOURNAL
 ABSTRACT

Methods and
materials
Context TSD is prospective study
very important comprised of 300 Conclusion
Aims evaluate TSD
opinion in every post cases randomly Changes in body
from decrease in
mortem examination selected from weight, organ weight,
body weight, organs
lawyer will try to cadavers BMI and BSA can be
weight, BMI and BSA
exclude the evidences (Government used as on table rapid
in percentage
as they arent within Hospital, Rajkot from tool to evaluate TSD.
range of TSD Jan-2012 to May-
2013. Based on time
since death )

Keywords: TSD(Time Since Death); Organs Weight; Decomposition; BMI (Body Mass Index); BSA (Body Surface
Area).
 INTRODUCTION

various post mortem changes of

Time since death very important opinion the body which are grouped
immediate, early and late
in every case of post mortem examination
changes.

Cooling of body, rigor mortis, post mortem lividity are common day to
day parameters used to estimate TSD in fresh cases.

M DD, M MP, R VP, N PM, K MR. An Autopsy Study to Evaluate Time Since Death from Organs Weight and Physical
Parameters. 2016;9(2):5-9.
 INTRODUCTION
Opinion of TSD is based
on combination of post
mortem changes every case, lawyers will try
distributed over the to exclude the evidences as
range and there is no they are not within range of
numerical parameters time since death.
to decide it

In this study, an attempt

is made to include new
numerical parameters
like decrease in body
weight and organs
weight along with post
mortem changes to opine
about TSD.
 MATERIAL and METHOD

This study was conducted on 300 subjects randomly selected from cadavers
brought for autopsy at mortuary of Government Hospital, Rajkot from Jan-2012
to May-2013.

Cases in which organs were injured, bodies having disease affecting

body weight or organs weight, having congenital anomalies of organ

Cases in which bodies were mutilated or damaged by creature to any

extent were excluded

Brain, heart, lungs, liver, spleen and kidneys were the organs
included in this study.

Standard
autopsy
In decomposed cases, organs were weighed till their architecture was intact
Body length was measured
from top of head to heel with
measure tape by measuring
distance between wooden
blocks placed at both ends. BMI
and BSA were the physical
parameters using DuBois
formula from Body weight and
length.
METHOD
The body and organs were weighed
using electronic weighing machine
TSD within 6hours
To correlate TSD with
body weight and organ decomposed cases
with TSD within 1-
weight, we have
divided TSD in fresh 3days
cases(FC)
3-5days and >5days.
 RESULT and DISCUSSION
Table 1. Distribution of cases in relation to TSD
Fresh cases are TSD (Time since death) No. of cases % out of total cases
maximum in number
<6hours (fresh cases) 250 80%
(80% of total cases) and
values of their physical 1-3 Days 16 6.4%
parameters and organs
3-5 Days 25 10%
weight are considered as
normal values for adults >5 Days 09 3.6%
in Rajkot region. Total 300 100%
 RESULT and DISCUSSION
TSD Mean Body Weight Mean Body Mean of BMI Mean of BSA
Length

<6hours 59.36 kg 100% 161.32 22.80 100% 1.62 100%

1-3 days 36.25 kg 61.06% 158.37 14.50 63.59% 1.30 80.24%

3-5days 32.04 kg 53.97% 160.84 12.5 54.82% 1.24 76.54%

>5days 25.22 kg 42.48% 163.00 9.5 41.66% 1.14 70.37%

As TSD increases, Doesnt shows significant BMI and BSA are parameters which
significant decrease in variation with TSD are dependent on body weight and
body weight as well in body length shows changes in
organ weight is noted. accordance with body weight
 RESULT and DISCUSSION
Table 3. Mean of organs weight in relation to TSD
TSD Mean Mean Mean Mean Mean Mean Mean Mean
weight of weight of weight of weight of weight of weight of weight of weight of
brain heart right lung left lung liver spleen right left kidney
kidney
Fresh cases 1229.07 303.01 439.12 384.19 1296.32 113.04 127.69 115.28

1-3 days NA 221.06 335.00(76. 288.81 790.75(60. 50.75 76.18 71.68

(72.95%) 28%) (75,10%) 99%) (44.89%) (59.66%) (62.71%)
3-5 days NA 174.20 277.88(63. 245.24 633.88(48. NA 73.00 66.80
(57.48%) 28%) (63.83%) 89%) (57.16%) (57.94%)
>5days NA 145.00 205.33 189.11 430.77(33. NA 52.22 47.33
(47.85%) (46.57%) (49.22%) 23%) (40.895%) (41.05%)
Weight of brain is not available
Out of all organs Weight of spleen is reduced to
in cases with TSD ismore than heart and lungs
50% of its normal values in
brain and spleen are were late to
1day. cases where TSD is within 1-3
the earliest organs to days and is not available in decompose.
decompose. cases with TSD>3days.
 CONCLUSION
As TSD advances, body weight and organs weight decreases
Out of all physical parameters body weight and BMI show significant
decrease with TSD
Brain and spleen decomposes earlier, organs like liver and kidneys are next to
decompose and their rate of decomposition is less as compared to brain and
spleen.
Spleen is reduced to 50% of its normal weight by end of 1day after death
and is completely decomposed in cases with TSD more than 3days.

This differential rates of decomposition of various organs as well as

changes in body weight, BMI and BSA can be used as on table tool to
evaluate TSD. .
LITERATURE REVIEW
 The Signs Of Death
Insensibility and
Immediate (somatic
loss of voluntary
death)
power
Cessation of
respiration
The Signs Of Cessation of
Early (cellular death)
circulation
Death

Late (decomposition
and decay)

Reddy KSN. The Essentials of Forensic Medicine and Toxicology. 32nd ed. Hyderabad: K Suguna Devi. 2013; p.105-115,161-164,642
 Pallor and loss of Pupils soon after death
slightly dilated (relaxation of Changes in the eye
elasticity of skin muscles of the iris)
Opacity of the
Retinal Vessels pale for
cornea drying
the first 2H
and is delayed 2
Primary
flaccidity of Early (cellular death) hours if the lids are
closed after death
muscles
The difference in temp body : Flaccidity of the
medium Eyeball look
Cooling of the sunken and become
Proportional of the weight of the
body (algor softer within
body to its surface area
mortis) minutes due to
The physique of the cadaver
Environment of the body reduction of TIO
Covering on or around the body
Reddy KSN. The Essentials of Forensic Medicine and Toxicology. 32nd ed. Hyderabad: K Suguna Devi. 2013; p.105-115,161-164,642
 Post mortem
Rigor mortis
lividity
Does not start in
all muscles Livor mortis
purple-red
simultaneously
first appears in Early (cellular death) coloration on
involutary muscle ( dependent
eyelids, neck and portions of the
body other than
lower jaw, and
passes upwards to
areas exposed to
the muscles of the pressure
face lastly in
the fingers and
toes)
Reddy KSN. The Essentials of Forensic Medicine and Toxicology. 32nd ed. Hyderabad: K Suguna Devi. 2013; p.105-115,161-164,642
 Late (decomposition and decay)
A fifth and final stage termed skeletal was added by Goff, these stage include :
1. Fresh stage
2. Bloat stage
3. Decay stage
4. Dry Stage
5. Skeletal stage

ModiJP.Textbook of Medical jurisprudence and Toxicology. 24thed. Gurgaon: Lexis Nexis. 2012; p.303-305,348-350
 Larynx and Stomach and Liver (12-24h) Gallblader (24h)
trachea (12-24h) intestines (24-36h) smooth and gall fluid spreads to
Mucosa turn reddish black spots on tender bulla tissues surrounding
brown green post.wall anterior formed on the the gallbladder
and tender wall surface

Decomposition of the Heart (2-3D)

Brain(1-2D) organs tender and
tender and dough brownish size
3rd day pasta and weight
like for 4th days decrease
Omentum/Mesenteri
disolve into liquid
um (2-3D)
greenish grey until
ModiJP.Textbook of Medical jurisprudence and Toxicology. 24thed.
Gurgaon: Lexis Nexis. 2012; p.303-305,348-350 almost black
 Lungs (2-3D) Kidneys (2-3D) Prostate/uterus
darker brownish red Bladder (longer genitals like the
partly collapsed tender and oily in than other prostate and the
collapse touch smaller with organs) uterus will take the
small and black timer darker longest to
decompose

Decomposition of the Diaphragma

Blood Vessels organs (longer time to
(long time) decompose)
eventhough its bcause of
components are composition of
already a mixture fibromuscular
of bloods exposed tissues
ModiJP.Textbook of Medical jurisprudence and Toxicology. 24thed. Gurgaon: Lexis Nexis. 2012;
p.303-305,348-350
CRITICAL APRAISAL

The objective of this research is
usefull to evaluate time since death
Prospective study
Characteristic of the sampels were
similar with the characteristic of
Indonesian people
The study has proven the theory of
decomposition
Presents a new way to evaluate TSD
using the changes of body weight,
organ weight, BMI and BSA.
The method of randomization doesnt
well-defined
The sampels didnt have similar
characteristics at the beginning of the
study
The autopsy technique was not
described in sufficient detail
Statistical analysis was not performed
The study has a wide range in
classifying TSD
No other journals were used to
compare
Less references were used
STUDY FOR COMPARISON
ThankYou