Srpski arhiv za celokupno lekarstvo 2012 Volume 140, Issue 3-4, Pages: 198-203
https://doi.org/10.2298/SARH1204198Z
Full text ( 223 KB)
Near-hanging with outliving period: Pathoforensic aspects
Živković Vladimir (Institut za sudsku medicinu, Medicinski fakultet, Beograd)
Nikolić Slobodan (Institut za sudsku medicinu, Medicinski fakultet, Beograd)
Introduction. Hanging usually ends in death, and about 80% of victims are
found dead at the scene of the hanging. However, sometimes the hanging
victims overlive for some time, and sometimes even survive the hanging.
Objective. The aim was to determine the causes of death in nearhanging cases,
in people who have been outliving hanging for some time, to explain the
pathophysiological mechanisms leading to death, and to identify prognostic
factors for this outcome. Methods. Retrospective autopsy study was performed
for a twelve-year period. There were only seven cases of near hanging. The
sample was analyzed according to gender, age, circumstances of death, and
autopsy findings of all observed subjects. The relevant data were collected
from autopsy records, police reports and heteroanamnestic interviews.
Results. The sample consisted of five men and two women, average age
48.3±19.9 years (29-81 years). The average outliving period was 3.8±2.6 days
(from 7 hours to 7 days). Six people were admitted to hospital in the state
of deep coma. In six cases cardiopulmonary arrest occurred after the hanging
attempt and all were reanimated for a shorter or longer time until admission
at hospital. Conclusion. Survival after attempted suicide by hanging occurs
extremely rarely. In all the cases, the immediate cause of death after
attempted hanging was ischemic brain injury, with a significant and
pronounced oedema. In all the cases observed, regardless of the presence or
absence of injuries of soft and hard structures of the neck, there was a
ligature mark on the neck skin. Acute hemorrhagic gastritis with melaena was
present in a significant number of reported cases of near-hanging.
Keywords: near-hanging, overliving period, autopsy, forensic pathology