Abstract
Hanging is one of the most common methods of painless suicide in India. Hanging is a form of asphyxia which is caused by the suspension of the body by a ligature encircling the neck, where the constricting force is the weight of the body. In most cases of hanging cases, the death of the individual occurs immediately or the usual average period is about 3 to 5 minutes. Causes of death in case of hanging are asphyxia, venous congestion, cerebral ischemia, carotid compression or fracture of vertebrae resulting in penetration into the spinal cord. In this article, the authors report a rare case of a 19-year-old male individual, who attempted suicide by hanging, survived for 7 days in ICU in an unconscious state and then died after the best efforts of the ICU team. Delayed death in hanging can be due to aspiration pneumonia, oedematous or haemorrhagic swelling of pharyngeal tissues or aryepiglottic folds, emphysema, infections, oedema of the larynx, lungs and brain pathology like an abscess, hypoxic encephalopathy, infarction and softening. In post-mortem examination, the doctor must remove the ligating material after carefully preserving the knot, and look for any marks of injury or struggle that may suggest the violence leading to strangulation. Prolonged resuscitative measures must be tried in all the victims of attempted hanging, and a guarded prognosis must be described.
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