Any disease that causes a rapid loss of blood may cause sudden death. Obviously, trauma such as a gunshot wounds, stabbings, and blunt trauma can cause sudden death from bleeding, but these rarely present a problem in interpretation for the investigator. Abundant blood at the scene does not necessarily mean foul play. The investigator needs to observe the location of the blood and the degree of or lack of spattering. Abundant blood spattering usually indicates trauma to the body with blood being thrown around, especially if the spattering is located high on the walls or ceiling.
Natural deaths may be associated with abundant blood near or away from the body. Chronic alcoholics may have such advanced disease that they may bleed from the mouth or the rectum or both. This is caused by liver damage (cirrhosis) in which blood begins to back up in the veins of the esophagus and the rectum. These thick and swollen veins are called varices. Varices have a tendency to rupture, and when they do, the bleeding may be quite extensive. The decedent may die within minutes, although the time is usually longer. There may be abundant blood in the toilet, bathtub, on towels, or in cups.
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