Abstract
Introduction: Asphyxia could occur in various situations like: Traumatic asphyxia, Hanging, Choking, Smothering, Strangulation, poisoning, etc. There are both external and internal general features to diagnose fatal asphyxia macroscopically such as: a) External (i) ligature mark (ii) congestion, cyanosis & petechial hemorrhages. b) Internal – fluidity of blood, dilatation of right chamber of heart and visceral congestion. Materials and Methods: An observational Cross sectional study was carried out in Department of Forensic Medicine & Toxicology, Santosh Medical College, Ghaziabad. A total 58 cases of fatal neck compression were included in this study during. All the cases with alleged history of fatal neck compression were included in the study, except where the dead body was severely decomposed, that would effect the observation of findings. In study the aim was to find out the different associated lesions, injuries / fracture of the organo-complex of the larynx, bleeds in the tongue, hemorrhage in the tonsils and tonsilar beds. Results: Majority cases of hanging were seen in young adult age group of 20 ± 30 years. The overall male : female ratio in cases of hanging was 11:1. Majority cases of hanging were suicidal. Neck compression and hanging were seen between time interval of 6 + AM to 12 noon. Congestion of the face was observed in 60.86%. Hemorrhage in Sub-conjunctiva, strap muscle, tongue, epiglottis and tonsil were seen in 13%, 23.91%, 13.04%, 20% and 15.21% cases respectively. Hyoid bone fracture was present in 13.04% while thyroid cartilage fracture was present in 4.34%. Conclusion: According to the present study hanging is more common in young adults mostly suicidal in nature. congestion of face is most significant external feature in hanging while tonsillar heamorrage is significant internal feature. Keywords: Hanging, Asphaxia, External neck injury, Internal neck injury, Ligature mark.
Highlights
Asphyxia could occur in various situations like: Traumatic asphyxia, Hanging, Choking, Smothering, Strangulation, poisoning, etc
Most male hangings occurred between the time interval of 6+ AM to 12 noon, while most female hangings occurred between the time interval of 12+ noon to 6 PM
Congestion of the face was observed in 60.86%, ear congestion was seen in 9 cases of hanging and sub-conjunctival hemorrhages were seen in 13% cases of hanging strap muscle hemorrhage was found in 23.91% cases
Summary
Asphyxia could occur in various situations like: Traumatic asphyxia, Hanging, Choking, Smothering, Strangulation, poisoning, etc. In parts of United Kingdom some 90% of suicides are due to hanging.[2] In Oslo and Copenhagen capital areas, 22% of all homicides were due to asphyxia and 73% of all these victims were females.[3] Over the past years, 7.4% of deaths caused by strangulation in Peoria County, involved children less than 18 years of age.[4] In Imphal (India) among 142 cases of violent asphyxial deaths during the 5-year period (1992-1996), hanging (43%) was the commonest type followed by drowning (34.5%), strangulation (9.9%) and traumatic asphyxia (5.6%).[5] According to an epidemiological study conducted in the department of forensic medicine, University College of medical sciences, during the 10-year period from 1993-2002, the incidence of violent asphyxia was 8.15% in the east Delhi.[6]
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