Forensic pathologist Dr Simon Stables said his post-mortem examination found extensive multiple fractures and widespread bruising, consistent with significant blunt force trauma.
"These sorts of significant fracture patterns you don't see in falls," Stables said.
"We only see them in high trauma cases, or an assault or a similar degree of force in a motor vehicle crash.
"We don't see this type of multiple fractures to different planes of [the] face and head in falls, this is more indicative of a significant blunt force assault."
There were numerous facial fractures, including to the skull, eye sockets, jaw, nose, cheek and two small fractures behind the eyes.
Stables said there was lots of bruising around the eyes and face, and extensive bruising extending down the neck onto the front of the chest.
There was almost continuous bruising in those areas, generally due to blunt force trauma, and the impact was with "enough force" to also cause underlying internal damage.
When asked by Crown prosecutor Richard Jenson about the blunt force trauma Hilton suffered, Stables said he could not say how many blows or impacts he sustained.
"There were multiple blows but I cannot tell you how many blows or impacts there were to have caused the widespread bruising and multiple fractures," he said.
Stables also said there were several injuries around the scalp, including abrasions or grazes to the front and back of Hilton's head, including to the temple.
There was also an unusual injury behind the right ear, where the skin was split, which could have been caused by a punch or possibly a kick, he said.
Stables said there was a lot of bruising to the lips and tongue plus a laceration inside his mouth.
This was consistent with Hilton having suffered "blunt force trauma", he said.
Stables said there was also bruising to the left elbow, inside of one lower leg and to Hilton's arms, wrists and hands, some of which could be "defensive" bruising.
He was unsure what caused bruising on the front of one wrist.
"It could be from a fall but it could also be someone trying to protect themselves."
Stables said internal examination of Hilton's body revealed one of the chambers of his heart was enlarged, he suffered from emphysema and had a small tumour in his lungs.
However, that was not directly related to his death, he said.
A vertebrae disc in Hilton's neck was split, which was consistent with a fall, but again this did not contribute to his death, Stables said.
The brain also showed signs of Alzheimer's disease and evidence of deep brain damage indicative of significant trauma.
His conclusion in terms of the cause of death was complicated by the acute chest infection Hilton suffered while in Tauranga Hospital, directly related to his head injury.
Stables said ultimately the head injury and other injuries were due to a high-level force, which could be from the deceased being punched, stomped on and kicked.
"From the pattern of injuries, I don't believe a fall has caused these substantive injuries."
The trial continues today.
Police describe arriving at victim's property
Yesterday afternoon images of bloodstained carpets and a dishevelled crime scene were shown to the jury as police and forensic experts gave evidence.
Detective Senior Sergeant Michael Hayward said he and a colleague from the Whakatāne criminal investigation branch arrived at Hilton's Ford St home around 11am on July 8.
They secured the property before doing "reconnaissance" outside the house, locating a packet of cigarette filters, then going inside.
A video shot on Hayward's iPhone was shown to the jury.
The footage tracked through the home and into the lounge, where Hilton had been found in a serious condition hours before.
Bloodstains could be seen on the carpet, particularly near the fireplace where Hilton was found.
Hilton's home was in a dishevelled state. In Hayward's field notebook, he remarked, "it is hard to tell if anything had been disturbed due to the general messiness of the room".
Police found a bloodstained tea towel stuffed behind an armchair cushion and a beer bottle. Evidence seized included cigarette filters, beer bottles, two blankets, a cardigan, the tea towel, furniture and curtains from the lounge, three cellphones and Hilton's wallet.
Forensic scientist Douglas Elliot from the Institute of Environmental Sciences Ltd did not examine the scene himself but spoke on behalf of his colleague, forensic scientist Rian Morgan-Smith, about his findings from an extensive examination with a particular focus on blood splatter presence and analysis.
Saturation, contact and transfer bloodstains were found at the scene as well as stains synonymous with blood exhaled from the mouth or nose.
Elliot described the area where bloodstains were found in the lounge as a "broad area", with drip, saturation and transfer stains.
- Additional reporting: Hazel Osborne, Whakatāne Beacon
