A 35-year-old male is found dead in his apartment 48 hours after being last seen alive. On external examination, the body shows a greenish discoloration starting from the right lower abdomen, which has spread to involve the entire abdomen and lower chest. The skin appears blistered in areas. Which of the following post-mortem changes is BEST described by these findings?
A. Mummification with adipocere formation
B. Putrefaction with post-mortem hypostasis
C. Algor mortis with post-mortem lividity
D. Rigor mortis with livor mortis
Explanation
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The clinical presentation describes putrefaction, the decomposition of body tissues by bacterial action, which is the most advanced post-mortem change visible at 48 hours in normal environmental conditions.
Characteristic Features of Putrefaction:
Greenish discoloration: Begins over the right lower abdomen (caecal region) where bacterial flora is highest; caused by hydrogen sulfide reacting with haemoglobin to form sulphaemoglobin
Spread pattern: Progresses centrifugally (outward) from the abdomen to involve the chest and extremities
Blistering (post-mortem blistering): Caused by gas accumulation beneath the epidermis; appears as fluid-filled vesicles
Timeline: Becomes visible within 24–48 hours under normal tropical/temperate conditions; accelerated by heat, humidity, and obesity
Why Putrefaction Occurs:
Bacterial proliferation in the intestinal tract (especially anaerobes like Clostridium and Bacillus) produces gases (H₂S, NH₃, CH₄) and pigments that discolour tissues and cause bloating.
Clinical Pearl
The right lower abdomen is the classic site of first appearance because the caecum harbours the densest bacterial flora.
High-YieldNEET PG
Putrefaction is temperature-dependent; it progresses 8× faster at 37°C than at 4°C.
