HOMICIDE OR A SUDDEN DEATH? RUPTURE OF VARICOSE VEINS – CASE REPORT

B. Mileva, I. Tsranchev, M. Angelov, I. Brainova, M. Georgieva, K. Peev, A. Alexandrov, L. Jelev, M. Goshev

Abstract: Introduction. Chronic venous insufficiency is a condition that occurs when the venous wall and/or valves in the leg veins are not working effectively. One possible complication is the formation of skin ulceration and its consequent rupture, which can be spontaneous or due to mild or trivial trauma. Sometimes the resulting haemorrhage is fatal. At the death scene – a large amount of blood may be present, which may lead to the hypothesis of violent death.
Case presentation. An unidentified male was found dead on the street. Around the deceased, there was a pool of blood and his trousers were soaked with blood. Due to the peculiarity of the case, the body of the deceased was sent for an autopsy with suspicions of possible homicide or traffic accident.
Discussion. Varicose veins are enlarged, thick and tortuous veins usually found in the lower limbs, associated with valvular incompetence. Ulcerations and bleeding are known complications of chronic venous disease, and they are usually considered non-lethal. When a fatal haemorrhage occurs the presence of a large amount of blood at the death scene rise suspicions of a possible crime.
Keywords: Chronic venous insufficiency, varicose veins, varices, ruptured varicose vein, autopsy, crime scene investigation.