International Journal of Legal Medicine

, Volume 131, Issue 5, pp 1423–1428 | Cite as

Hypothermia provokes hemorrhaging in various core muscle groups: how many of them could we have missed?

  • Lenka Zátopková
  • Petr Hejna
  • Cristian Palmiere
  • Grzegorz Teresiński
  • Martin Janík
Original Article


The postmortem diagnosis of hypothermia remains problematic even in the era of molecular and digital diagnostic advances. Gross hemorrhages in iliopsoas muscles have been regarded as a helpful diagnostic sign in hypothermia fatalities; nevertheless, they have received marginal attention since their original description. The present study attempts to fill that void by examining occurrence, localization, and diagnostic significance of the bleeding into the core muscles as evidence of death due to hypothermia in a series comprising 51 consecutive hypothermia autopsy cases. Hemorrhages into the core muscles were identified in 33 cases of fatal hypothermia (65%). Hemorrhages were present in iliopsoas muscles (19 cases; 37%), deep back muscles (18 cases; 35%), and in other core muscular groups such as the diaphragm, cervical, pectoral, and intercostal muscles (11 cases; 22%). The results of the study offer an attractive diagnostic opportunity and reaffirm the potential of the careful core muscle dissection for the clarification of hypothermic deaths. Centers lacking high-end imaging technologies and molecular postmortem programs may especially benefit, which may have implications in broader autopsy practice.


Fatal hypothermia Core muscle Hemorrhage Autopsy Postmortem diagnosis Forensic pathology 

Supplementary material

414_2017_1596_MOESM1_ESM.pdf (87 kb)
Scheme 1 The entanglement of pathogenetic linkages leading to muscular hemorrhages in hypothermia fatalities (supplementary material) (PDF 87 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Lenka Zátopková
    • 1
  • Petr Hejna
    • 1
  • Cristian Palmiere
    • 2
  • Grzegorz Teresiński
    • 3
  • Martin Janík
    • 4
  1. 1.Department of Forensic MedicineCharles University, Faculty of Medicine and University Hospital Hradec KrálovéHradec KrálovéCzech Republic
  2. 2.CURMLLausanne 25Switzerland
  3. 3.Chair and Department of Forensic MedicineMedical University of LublinLublinPoland
  4. 4.Institute of Legal Medicine and Medico-legal Expertise, Jessenius Faculty of MedicineComenius UniversityMartinSlovakia

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