Death due to unusual position of the body--an explanationfor the consequence of reduced venous reflux to the heart

The article describes the case of a 29-year-old woman who was found dead in her apartment on a bar stool with the body being maximally retroflected in the lumbar region, the head hanging down and the feet and hands barely touching the floor. On external inspection of the body the cuff-like distribution of hypostasis on the forearms and lower legs was consistent with the position in which the body was found. There were no signs of foreign intervention. At autopsy massive congestion was found in the internal organs as well as pulmonary and cerebral edema. In the ventral region of the lumbar intervertebral discs superficial hemorrhages were detected. The alcohol content was 3.40 per thousand in the blood and 4.43 per thousand in the urine. As the essential pathogenetic mechanisms responsible for death reduced venous reflux to the heart in combination with postural asphyxia and the influence of alcohol are discussed.