Question #148 (5/15/2026)

National Association of Medical Examiners 
Educational Activities Committee

Submitted by Dr. Bartlomiej Radzik (Assistant Medical Examiner), Dr. Benjamin Soriano (Assistant Medical Examiner), and Dr. Lorenzo Gitto (Assistant Medical Examiner, Research Director) from the Cook County Medical Examiner’s Office, Chicago, IL, USA.
1.An adult female was found dead beneath bushes along a city sidewalk with initial suspicion of foul play. At autopsy, the finding seen in the photo was identified.

Based on the provided image, what is the most likely cause of the observed finding?