Livor Mortis

What Is It, Occurrence, and More

Author: Lily Guo

Editors: Ahaana Singh, Lisa Miklush, PhD, RN, CNS

Illustrator: Aileen Lin


What is livor mortis?

Livor mortis, also known as post-mortem lividity or post-mortem hypostasis, refers to the pooling of blood in the lower portion, or dependent parts, of the body after death. This results in a dark purple discoloration of the skin. Livor mortis is one of the four post-mortem signs of death and occurs as a result of the heart no longer pumping and moving blood through parts of the body. Consequently, gravity causes the red blood cells to sink and pool in the dependent parts of the body. 

What does livor mortis mean?

Livor mortis is a Latin term that literally translates to “discoloration of death”.

When does livor mortis set in?

Livor mortis begins appearing as dull red patches after 20 to 30 minutes from the time of death. Over the next 2 to 4 hours, the patches come together to form larger areas of bluish-purple discoloration. At this point, the skin is blanchable, meaning that it can take on a whitish appearance when pressure is applied due to the diversion of blood flow from that region. Blanching can last for up to 8 to12 hours after death. Once pressure is removed, the blood will usually return to the pooled location, appearing bluish-purple in color again. After 12 hours, the skin typically becomes non-blanchable or fixed, meaning applying pressure on the skin during this period will no longer lead to a whitish discoloration. 

Forensic investigators often use these signs to determine the estimated time of death in crime scenes. Assessing livor mortis can also be useful in determining the cause of death, particularly in cases such as hypothermia, carbon monoxide poisoning, and cyanide intoxication, as such factors can lead to livor mortis taking on a variety of distinguishing colors. 

What is the difference between livor mortis and rigor mortis?

Rigor mortis is another post-mortem sign of death and refers to the stiffening of the muscles. Unlike livor mortis, which develops less than an hour from the time of death, rigor mortis begins 2 to 4 hours after death and develops fully by 6 to 12 hours. Stiffening occurs as cells in the body are broken down by digestive enzymes and intracellular calcium is released. This results in continuous muscle contraction since calcium is a necessary component in initiating contraction. Another cause of rigor mortis is the lack of adenosine triphosphate (ATP), or the energy molecules in the muscle cells. After death, oxygen is unable to reach muscle fibers and ATP is no longer produced. This, along with the build-up of lactate and phosphate in muscle tissue, results in an acidic environment that promotes the binding of actin and myosin fibers of the muscle. The muscle remains contracted as long as the actin and myosin fibers of the muscle are bound. Rigor mortis can last anywhere from one to four days, after which the muscles become limp again. Lower temperatures speed up the onset of rigor mortis and prolong its duration, whereas warmer temperatures will slow the onset and shorten its duration. 

The remaining two post-mortem signs of death include pallor mortis and algor mortis which both occur shortly after the heart stops beating. Prior to both livor mortis and rigor mortis, the body goes through pallor mortis, or the development of pale skin, and algor mortis, the cooling of the body after the body is no longer producing heat. 

What are the most important facts to know about livor mortis?

Livor mortis is the gravitational settling of blood which is no longer being pumped through the body after death, causing a bluish-purple discoloration of the skin. It is one of the post-mortem signs of death, along with pallor mortis, algor mortis, and rigor mortis. Livor mortis usually sets in 20 to 30 minutes after death and increases in intensity until it becomes fixed at about 12 hours. Assessment of livor mortis can be useful in determining the approximate time of death or cause of death, based on the approximate stage of lividity and the specific coloration.

Related links

Lividity
Skin anatomy and physiology

Resources for research and reference

Dix, J. (2017). Time of Death, Decomposition and Identification: An Atlas. Boca Raton, FL: CRC Press.

Lee Goff, M. (2009). Early post-mortem changes and stages of decomposition in exposed cadavers. Experimental and Applied Acarology, 49: 21–36 . DOI: 10.1007/s10493-009-9284-9

Mathur, A. & Agrawal, Y. K. (2011). An overview of methods used for estimation of time since death. Australian Journal of Forensic Sciences, 43(4): 275–285. DOI: 10.1080/00450618.2011.568970

Schäffer, B. & Peschel, O. (2018). The Differential Diagnosis of Light-Red Livor Mortis. Deutsches Aerzteblatt International, 115(35–36): 585. DOI: 10.3238/arztebl.2018.0585