Death, Post Mortem Changes and Decomposition on Post Mortem Computed Tomography

Essence of postmortem computed tomography for in-hospital deaths: what clinical radiologists should know

“…Examples of early postmortem changes include pallor mortis (the earliest change which reflects the external skin color change), algor mortis (the progressive decrease in body temperature), livor mortis as known postmortem hypostasis (the non-circulating blood and other fluids settle with gravity toward the dependent parts of the body), and rigor mortis (stiffening of muscle). However, some changes, such as pallor mortis and algor mortis, cannot be visualized on CT scans [ 17 ], although low temperature induces density changes in tissue and associated CT value changes. Meanwhile, findings reflecting the cessation of circulation are observed after death.…”

“…In contrast, a cast-like hyperattenuating area can be seen in the pulmonary artery and aorta during the long death phase and in the agonal stage of chronic disease (Fig. 2 ) [ 22 ]. Subcutaneous edema and skin thickening can also occur and are generally symmetrical [ 23 ].…”

“…Gas production can occur in blood vessels and organs (Fig. 1 f) because of the decomposition or presence of gas-producing bacteria in the vasculature and intestinal tract, even in cases where cardiopulmonary resuscitation was not performed [ 39 ]. (Gas production reflecting post-cardiopulmonary resuscitation changes is discussed later.)…”