A 42-year-old man is found dead in his locked apartment in Delhi during summer (ambient temperature 38°C). The body is discovered by neighbours 72 hours after he was last seen alive. On external examination, the body shows greenish discoloration over the right lower abdomen, with blistering of the skin and separation of the epidermis. The cornea is hazy and the pupils are dilated. There is no rigor mortis. What is the most likely post-mortem interval?

Question

Accepted Answer

A. 48–72 hours. ## Post-mortem Interval Estimation

### Key Observations in This Case

**High-Yield:** The combination of greenish discoloration over the right lower abdomen, blistering, epidermal separation, absent rigor mortis, and a hot ambient temperature (38°C) is consistent with a post-mortem interval of **48–72 hours**.

### Timeline of Post-mortem Changes

| Time Interval | Signs |
|---|---|
| 0–12 hours | Pallor mortis, algor mortis begins, rigor mortis starts (2–6 h), corneal clouding |
| 12–24 hours | Rigor mortis peaks, livor mortis fixed, early skin discoloration |
| 24–48 hours | Rigor mortis begins to fade; green discoloration appears over right iliac fossa (cecal putrefaction) |
| **48–72 hours** | **Rigor mortis absent; blistering and epidermal separation; advancing putrefaction** |
| >72 hours | Marbling, bloating, liquefaction, advanced skeletonization in extreme heat |

### Environmental Acceleration

**Key Point:** At 38°C, decomposition is accelerated approximately 2–3 fold compared to temperate conditions (~15–20°C). This means changes that normally appear at 72–96 hours in temperate climates can appear at **48–72 hours** in Indian summer conditions.

**Clinical Pearl:** In this case:
- **Greenish discoloration** over the right lower abdomen is the earliest sign of putrefaction, typically appearing at 24–48 hours in normal conditions but accelerated to ~24–36 hours in heat.
- **Blistering and epidermal separation** are mid-stage putrefactive changes, classically seen at 48–72 hours in hot climates — NOT exclusively a >72-hour finding.
- **Absent rigor mortis** confirms >36–48 hours have elapsed; in hot conditions, rigor fades by 36–48 hours (vs. 48–72 hours in temperate climates).
- The history states the body was found **72 hours** after last being seen alive — this is the *maximum* possible PMI, not a confirmed minimum. The decomposition pattern is consistent with 48–72 hours.

### Why Option D (>72 hours) Is Incorrect

The stem states the body was found **72 hours** after last contact — this sets an upper bound of 72 hours on the PMI. The decomposition findings (blistering + epidermal separation + absent rigor in 38°C heat) are fully explained by a 48–72 hour interval. Signs that would specifically indicate **>72 hours** — such as marbling of skin, bloating/gaseous distension, liquefaction, or advanced skeletonization — are **absent** in this case. Selecting >72 hours would contradict the known timeline.

**High-Yield (Modi's Medical Jurisprudence & Toxicology / Parikh's Textbook of Medical Jurisprudence):** In hot tropical climates, blistering and skin slippage are hallmarks of the **48–72 hour** post-mortem window. The PMI here is **48–72 hours** (Option C).

Answer

B. More than 72 hours

Answer

C. 12–24 hours

Answer

D. 24–48 hours

Explanation

Post-mortem Interval Estimation

Key Observations in This Case

Timeline of Post-mortem Changes

Environmental Acceleration

Why Option D (>72 hours) Is Incorrect

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Time Interval	Signs
0–12 hours	Pallor mortis, algor mortis begins, rigor mortis starts (2–6 h), corneal clouding
12–24 hours	Rigor mortis peaks, livor mortis fixed, early skin discoloration
24–48 hours	Rigor mortis begins to fade; green discoloration appears over right iliac fossa (cecal putrefaction)
48–72 hours	Rigor mortis absent; blistering and epidermal separation; advancing putrefaction
>72 hours	Marbling, bloating, liquefaction, advanced skeletonization in extreme heat