One of the pathologists at the inquest on Stuart Lubbock also suggested he could have been asphyxiated.
A post-mortem examination carried out on the 31-year-old after he was found at 50-year-old Barrymore’s home in Roydon, Essex, on March 31 last year gave the official cause of death as drowning, the inquest in Epping was told.
But Professor Christopher Milroy and Professor Jack Crane told the inquest that because pinhead size haemorrhaging found on Mr Lubbock’s body was not normally associated with drowning, other possibilities had to be considered.
Professor Crane, the state pathologist for Northern Ireland who based his findings on witness statements plus reports from toxicologists and pathology colleagues, said it was a possibility Mr Lubbock drowned.
The description of the appearance of the lungs and an absence of “tenacious foam” common in drowning victims made drowning less likely, but he accepted that lengthy attempts to resuscitate Mr Lubbock may have obscured the findings.
The bleeding may have been the result of “some sort of asphyxial process such as compression or obstruction of the neck or air passage”, he suggested.
Referring to internal injuries found on Mr Lubbock’s body, the professor added: “Mr Lubbock sustained, in my view, very significant and serious injuries to the anal area.
“While I accept that injuries can occur during consensual sexual activity, I don’t believe that these injuries were the result of consensual sexual activity. In my view they were indicative of a serious sexual assault. “I think something had been inserted forcibly into the anus. It caused bruising, laceration and dilation.”
Drowning, “asphyxial death”, cardiac arrest due to sexual activity or a combination of drugs and alcohol found in Mr Lubbock’s body should all be treated as “distinct possibilities” for his death, Professor Crane said.
Earlier, the inquest heard from Professor Milroy, a forensic pathologist who carried out a second post-mortem examination.
He said the bleeding could have been caused by Mr Lubbock being held around the neck.
Because the burst blood vessels were not commonly seen in drowning cases or often caused by resuscitation, he said it was impossible to exclude other possibilities and would lead him to be cautious in diagnosing immersion as cause of death.
Professor Milroy, backing up the conclusions of Dr Michael Heath, the Home Office pathologist who carried out the first post-mortem, said ecstasy found in Mr Lubbock’s bloodstream was of a similar concentration to that in people who had died after taking the drug.
All three experts agreed the combination of drugs, including cocaine, and alcohol would have affected the reactions and perception of Mr Lubbock, who came from Harlow, Essex.
He was found to be more than three times the legal drink-drive limit with a reading of 223mg of alcohol per 100ml of blood.
Earlier Mr Mansfield read from witness statements which suggested Mr Lubbock had been in a Jacuzzi and “larking about” in and around the swimming pool.
The hearing was adjourned until tomorrow.
He stressed that there was no evidence in the witness statements that suggested Mr Lubbock had either suffered any kind of sexual assault or was in any kind of pain.
The inquest had earlier heard that the kind of anal injuries suffered by Mr Lubbock would have caused “excruciating pain”.