"Take notice of her position, the discoloring of her limbs and her stomach.
She was in full rigor mortis - which is present from 12-72 hours. The bruises set the time frame at around 8+ hours.
Her eyes had clouded, which happens at progressively from about 2 -4 hours on.
If you look really closely at her stomach, you can see a greenish tint, which is a typical sign of her internal organs decaying - called livor mortis. I think this process may have been accelerated as her insides were digested since it normally takes a few days to set in.
The bruises called for the autopsy. Because of her position when her stomach exploded, it spilled all its contents into her body cavity. The blood and food settled around her anus and vagina and caused what looked like "fresh bruises." So to rule out sexual [assault, etc.], they had to autopsy.
When they did the autopsy, they found that her stomach had been extended from where your ribs meet each other all the way to her pubic bone, right behind that pad of fat above the genitals (mons pubis). And her stomach had a large rip in it...
She also had some other abnormalities going on. Her heart was small and displayed typical characteristics of a starving heart - destroyed muscles and dead immune cells (lipofuscin bodies).
Her brain had swelled, my guess due to the massive increase in blood flow after her stomach ruptured - it had started to squeeze out her skull before she died.
She also had evidence of focal pneumonia in her lungs - not really surprising as starvation hurts the immune response to viruses.
Like a typical binger, her stomach was dying before it ripped. What I mean is that every time we binge our stomachs expand, if they expand far enough, the vessels supplying them blood are crushed - cutting off the blood supply to that area, killing the tissue. That area is weakened and the next binge of that caliber becomes more dangerous. Purging just adds fuel to the fire by increasing stomach pressure above and beyond the natural level.
But believe it or not the ruptured stomach didn't kill her. A natural reaction did.
When the stomach exploded, her body responded with a typical immune reaction. It dilated her blood vessels, her blood pressure dropped, she blacked out, and her heart slowed down and stopped. They also did a tox screen and found nothing. Potassium levels are obviously of no use as when you die potassium leaks out of your cells.
Another things to note about this. Back in the 1800s, they determined that the stomach should only be able to hold 4 liters of stuff (by filling corpses). To surpass this, we have to adapt our stomach sizes - resulting in gastric dilatation.
Ruptures via overfilling the stomach appear along the lesser curvature of the stomach, whereas vomiting induced ruptures normally occur along the greater curvature and fundus (the top of the stomach) - it's unusual that her stomach ripped how it did, right down the front.
Apart from the intellectual value of the report it does illustrate an important point - the endpoint of these diseases is very ugly.
There is no glamour or beauty spending your last living moments over a toilet."
Lähde I. Sinicina, , H. Pankratz, A. Büttner and G. Mall
Institute of Legal Medicine, Ludwig-Maximilians-University, Frauenlobstraße 7a, D-80337 Munich, Germany
Received 26 March 2004; accepted 26 October 2004. Available online 13 December 2004.