A case of fatal haemorrhage due to ruptured varicose veins

Presence of varicose veins in lower limbs is a common condition in the community affecting 14 to 59% of the population (1). It has been estimated that >20 million people in the United States have some form of symptomatic chronic varicose veinrelated conditions (2). Varicose veins appear as tortuous dilated veins with associated oedema and induration of the skin (1). The most frequently affected veins are the superficial veins of the lower extremities (3). While complications such as leg oedema, varicose eczema and ulceration are not unusual, fatal haemorrhage from rupture is a rare event in most forensic practices. This rupture can happen spontaneously or as a result of minor trauma and in general is not fatal (2). However, if unattended, a fatal outcome can occur in a small percentage of cases (3). The investigation of such cases is usually straightforward, although the amount of blood at the scene, and the elderly and frail nature of many of the victims may raise the possibility of an assault.