Blood extravasations in the vaginal and rectal mucosa: probably underdiagnosed findings in female victims of sexual homicide.

In suspected sex-related homicides, special attention is paid to morphological and trace evidence suggesting a sexual assault. As far as anogenital lesions are concerned, injuries may be located externally (affecting the vulva, perineum and anus) or internally. In the latter case, the vagina, the cervix and the rectal wall can be involved. Among the findings associated with sexual homicides, mainly striking injuries such as perforations, lacerations and deep abrasions of the vagina and/or rectum are mentioned in textbooks and autopsy reports. In contrast, the presence of non-penetrating mucosal lesions such as petechiae, ecchymoses and more extensive blood extravasation is rarely noticed. Based on two exemplary cases, the macroscopic and histological appearance of haemorrhages within the vaginal and rectal mucosa are demonstrated in synopsis with concomitant signs of anogenital trauma. Locally acting shear forces followed by ruptures of small vessels are considered to be the most important injury mechanism. Contributing factors may result from special circumstances of the individual case such as the offender's modus operandi.