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Petechiae

Definition

Pinpoint haemorrhages above the level of venous compression. They develop when venous outflow is blocked while arterial inflow continues, raising capillary pressure to rupture. Petechiae on the conjunctiva and facial skin support a strangulation mechanism.

Appearance
Pinpoint haemorrhages, typically under 2mm
Mechanism
Venous congestion with continued arterial inflow
Common sites
Conjunctiva and facial skin
Diagnostic role
Supports a strangulation mechanism

Common questions

Are petechiae exclusive to strangulation cases?+

No. They can also arise from forceful coughing, vomiting, childbirth, resuscitation attempts, or certain medical conditions, so their presence supports rather than confirms strangulation and must be interpreted alongside other findings.

Why might petechiae be absent even in a genuine strangulation death?+

If both venous and arterial flow are occluded quickly and completely, capillary pressure never rises enough to rupture vessels, which is one reason petechiae are often sparse or absent in rapid, complete airway and vascular occlusion.

Related terms

Carotid Artery Dissection
A tear in the inner wall of the carotid artery caused by stretching or compression during strangulation. Can produce stroke hours to...
Ligature Strangulation
Compression by a cord, belt, wire, or similar item looped around the neck. The ligature mark shows the width and pattern of...
Manual Strangulation
Compression of the neck by one or both hands. The most common type in intimate-partner violence. Creates asymmetric, fingertip-sized contusions and may...
Positional (Postural) Strangulation
Compression of the neck caused by the weight of the body or an external object constraining the airway or neck vessels without...
Strangulation Documentation Form
A structured clinical tool, developed originally by the Training Institute on Strangulation Prevention, that systematically prompts recording of mechanism, symptoms, and physical...

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