STUDY OF PATTERN OF CUT THROAT INJURIES Cut throat injuries pose a different type of challenge as to the causation whether it is homicidal, suicidal or accidental. They may be the only fatal injury or may be associated with other injuries. Thus opining the manner is difficult. Only after a careful examination of the wound characteristics, blood stain pattern on body, clothes and scene; causative weapon/ object, crime scene visit and circumstances of death can one conclude the manner. MATERIAL AND METHODS A retrospective study from January 2005 to December 2013 for a period of 9 years was conducted in the Department of Forensic Medicine, M.S. Ramaiah Medical College Bangalore, South India, 6710 medico-legal autopsy reports were reviewed. Of which 36 cases had cut throat injuries. Results and Discussion Of the 6710 autopsies, 36 cases had cut throat injuries (0.54% of total autopsies). Of these 36 victims, 27 were males and 9 were females. 32 (88%) were homicidal, 2 (6%) were suicidal and 2 (6%) were accidental in manner (Table No. 2). Cut throat injury alone was the main fatal injury in 24 cases and in 7 cases it was one of the major contributing injuries causing death and in 5 cases cut throat injury though present did not contribute to death. Cut throat injury was associated with other injuries in 29 (81%) of the cases (Table No. 3). Of which 19 cases (52%) were caused by sharp weapon, and 9 (25%) cases were due to blunt force in cases of homicide. Ingestion of poison in a case of suicide and fracture of cervical vertebrae were the other forms of associated injuries. There were no associated injury in both accidental deaths and one suicidal cut throat injury. In 7 (21%) of the 32 homicides attempt was made to conceal the identity or the crime. Of which 3 bodies were hidden viz. 1 in drain, 1 was in bushes and 1 was disposed off in a lake. In 2 cases which were found in open place, identity was concealed by disfiguring the face by crushing the head. Of the 32 homicidal deaths, in 4 cases weapons were found at the scene of occurrence, in 24 cases weapons were recovered later and in 4 cases could not be recovered. In all cases of suicides and accidental deaths, causative weapon/ instruments were found at the scene of crime. Haemorrhagic shock was the main cause of death in 33 cases (91%) either solely due to the severing of the great vessels or due to the combined bleeding from other injuries. 2 of them had asphyxiated after aspirating blood into the respiratory tract. Metabolic acidosis and shock caused death in one case where the person had consumed corrosive poison after inflicting a cut throat injury. In our study, the characteristics of the wound viz. situation, location, direction, multiplicity, wound margins, tailing were observed (Table No. 4). In 14 cases, the direction was below upwards and all were homicidal. (Fig No. 2) In homicides, it is commonly over or below the thyroid cartilage, horizontal or below upwards and deeper cuts. (Fig No. 3) Cut throat injury was single in all suicides, accidental and in 20 homicidal cases. 12 out of 32 homicidal cut throat injuries were multiple and were merged at a deeper level. There were other associated injuries and defence injuries in 29 cases and 12 cases of homicides. In cases of suicides, the injury is commonly located above the thyroid cartilage, over the left side of the neck above downwards with tentative and superficial cuts. Internal jugular vein (86%) was the commonly injured structure followed by carotid arteries (61%) and hypopharynx (41%). (Table No. 5) In all cases of suicidal and accidental deaths, deeper structures like oesophagus and vertebrae were spared. (Fig No. 4) In 41.7% of the homicide cases, notches in the vertebrae and in 25% medulla spinalis cuts were detected. (Fig No. 5) Presence of lesions on bone and cartilage has been reported to be a distinguishing property of homicides. In cases of suici