Some of the paragraphs detailed more than one injury, he said.

In response to questions from advocate depute James Wolffe QC, he agreed some of the marks they found were consistent with injuries he might expect to find on a little boy, described as, “boisterous”. Others could be explained by resuscitation attempts.

A single trauma could account for all the internal injuries found.

“It may be more, but there is no evidence to suggest it would be more,” he added.

The court has heard Brandon died as a consequence of a perforated gut, caused by blunt force trauma (see yesterday’s late evidence below).

Mr Wolffe asked if any other injuries were found.

Mr Howatson said that, in addition to the bruises, scratches and abrasions on the outer surface of the body, they also discovered fractured ribs on the left hand side of the chest.

The blunt force trauma, which “squashed and pressed” internal organs against the hard surface of the spine, causing the rupture, would have to be applied from the front towards the back.

In response to a question from temporary judge John Morris QC, he said it could not have happened from the rear, otherwise the force required would have fractured the spine.

The specialist child pathologist was asked to refine his estimate of the earlier injury at the same site as the perforated gut.

He said that, in addition to the rupture, microscopic examination revealed the presence of scarring from an earlier injury at the same site.

It could not have been earlier than four to five days before the fatal injury.

“I think it was probably two weeks, perhaps longer, based on the scarring.”

There was also evidence of bleeding from earlier injury in other areas of the abdominal cavity and around the diaphragm.

He detailed bruises and abrasions and scratches on both arms and hands and the right leg, as well as a complex series of bruises on the trunk.

In particular, he spoke of bruising at the back of the pelvis, running upward at a 45-degree angle towards the ribs which had bruising overlaid by scratches and abrasions.

Mr Howatson said additional marks below the scalp were found which were not apparent from external examination and the post-mortem also revealed damage to the fatty tissue of the abdomen, corresponding to marks seen externally.

Among the marks on the scalp was an area 12cm long by 11cm wide running from the top of the head to the front of the head which contained a number of sites of bruising.

Microscopic examination of 10 bruises on Brandon’s body was carried out and this revealed two fresh bruises — the area to the top of the head and to the centre of the back.

Bruising on the left and right side of the abdomen, at the level of the tummy button, the lower right abdomen, the right hip and the back of the head all fell within the range of two to five days before death.

The examination of bruising at the site of the lower right abdomen suggested the possibility of another injury subsequent to the original injury.

Asked to comment on the bruising, Mr Howatson said, “I think it is more likely different incidents at different times over a period of days.”

He was then asked to deal with the injury to the ribs.

Initial X-rays did not reveal any fractures, but bleeding deep in the chest cavity prompted further investigation.

This revealed healing fractures on the fourth, fifth, sixth and seventh ribs of the lower left chest.

Mr Howatson estimated the age of the fractures at two to three weeks.

The fresh bleeding was, in his opinion, attributable to CPR as part of resuscitation attempts.

The advocate depute asked if the rib injury could be part of the same event as the earlier damage found on internal organs.

Mr Howatson replied, “The time frame is similar but I cannot be certain either way.”

He was asked to comment on the nature and degree of force required to perforate the gut in the injury which led to death.

He said he did not know how much force would be required.

“If anybody saw this happening they would recognise a child had been hurt.

“It would be identified as out of the ordinary and injurious by anybody watching this,” he said.

Mr Wolffe asked if he had encountered such injuries before and if he knew of the ways such injuries could be caused.

He told the court that the first time he dealt with such a case as a surgeon involved a car mechanic falling into the engine compartment of a vehicle and making contact with his tools which were on the edge of the engine compartment.

Such injuries were seen in road accidents with high velocity impacts and he had also encountered the fatal injury in instances of violence against children.

He was asked if there was any bruising to the front of the abdomen which could be associated with the fatal injury. He said there was not, but the absence was well documented in medical literature.

All it meant was that the underlying blood vessels had been able to accommodate the force required to push the internal organs against the spine.

Mr Howatson said the only injuries which could be associated with the fatal rupture were the areas of grazing in the middle of the back. This could occur if the force to the front of the body was applied when the child’s back was against a hard surface.

The spine pressing against the hard surface with the skin between could cause such abrasions. He concluded, “There was more than one episode of injury over a period — from death, going back a few weeks.”

The fatal injury was caused by blunt force trauma, which was consistent with blunt force trauma being responsible for all injuries identified.

The trial continues.