Original Research Paper Indian Journal of Forensic Medicine & Toxicology

Volume 17 No. 2, April-June 2023

DOI: https://doi.org/10.37506/ijfmt.v17i2.18922

A Study of Postmortem Findings of Asphxial Deaths Due to

Hanging in a Semi Urban Region of Karnataka
Gopal B.K 1*, Subin B. George 2, Roopak S.N 3, Viswakanth B 4
1
Associate Professor, Department of Forensic Medicine and Toxicology, Kempegowda
Institute of Medical Sciences, Bangalore, Karnataka, India, 2Assistant Professor, Department
of Forensic Medicine and Toxicology, Malankara Orthodox Syrian Church Medical College,
Kolenchery, Ernakulam, Kerala, India, 3Assistant Professor, Department of Forensic Medicine
and Toxicology, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India,
4
Professor, Department of Forensic Medicine and Toxicology, Kanachur Institute of Medical
Sciences, Mangalore, Karnataka, India.

How to cite this article: Gopal BK, George SB, Roopak SN, Viswakanth B. A Study of Postmortem Findings of
Asphxial Deaths Due to Hanging in a Semi Urban Region of Karnataka 2023;17(2): 60-63

ABSTRACT
Hanging, a method of deliberate & intentional self-harm amounts for a major proportion of autopsies which
medicolegal experts encounter in their clinical tenure at various hospitals pan India. A retrospective study was
conducted in the Department of Forensic Medicine and Toxicology, Kanachur Institute of Medical Sciences,
Mangalore from Jan 2016 to June 2022, with an objective to study the post mortem findings in autopsy cases
of hanging. Out of 306 autopsies, 14.38 % cases were that of hanging with a female to male ratio being 3:1.
Most cases were atypical (81.81%,36) and partial hanging (72.72%, 32) with the ligature mark situated above
the thyroid cartilage. 86.36 % of cases (38) had dried salivary stain at the angle of mouth and one case showed
involuntary discharge. The incidence of fracture of hyoid bone and thyroid cartilage not observed in any cases.

Keywords: Violent asphyxia, Hanging, Autopsy, salivary stains, thyroid cartilage, hyoid bone.

INTRODUCTION knot, hanging is described under 2 headings –

Typical hanging where the knot is present at
Hanging is a type of violent asphyxial death
the occiput and atypical hanging where the
in which the neck is constricted with a
knot is at any other position.
ligature and the body is suspended wherein
the weight of the body acts as the constricting At autopsy, the classical signs of asphyxia
force. According to the literature, there are observed are cyanosis, congestion, petechial
two types of hanging that are documented haemorrhage, pulmonary edema and
i.e., hanging with complete suspension of the postmortem fluidity of the blood.1,8
body without the feet touching the ground A detailed assessment of various post-
(complete hanging); and hanging with mortem findings is always deemed mandatory
incomplete suspension, with parts of the body especially in a few cases where the ligature
or feet touching the ground (incomplete or mark produced due to the variable amount of
partial hanging). Based on the position of the pressure on the neck may create ambiguity.

Corresponding author: Gopal B.K, Associate Professor, Kempegowda Institute of Medical Sciences, Banashankari
Stage II, Banashankari, Bengaluru, Karnataka 560070.

Email Id: [email protected]

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In the current study it is attempted to get Out of 306 cases, typical hanging was
an insight into the post mortem features of found only in 8 cases (18.19 %) whereas most
deaths due to hanging in Mangalore region. of the cases 36 (81.81%) were atypical hanging.
Knot was on the left side of neck in 23 cases
MATERIALS AND METHODS (52.27%) (Table 1).
The study consisted of 44 hanging victims In the present study partial hanging was
out of 306 medico-legal autopsies performed seen in almost 3/4th of the deaths. Complete
in the Department of Forensic Medicine, hanging was accounted for 12(27.28%) deaths
Kanachur Institute of Medical Sciences, (Table2).
Mangalore, Karnataka during the period of
In our study, the level of ligature mark
5.5 years (from January 2016 to June 2022).
was above the thyroid cartilage in 38 cases,
Necessary information for the study was overriding the thyroid cartilage in 4 cases and
gathered from inquest report by the Police below the thyroid cartilage in 2 cases (Table 3).
and treatment records of hospital. Discussion
86.36 % of cases (38) had dried salivary
with relatives, friends, and neighbours of
stain at the angle of mouth and 2.27 % of total
the victims were also obtained separately for
case showed involuntary discharge.
additional data. In certain cases, crime scene
visits and review of the photographs were No incidence of hyoid bone and thyroid
utilized for supplementary information. cartilage fracture were observed in any of the
cases.
A detailed proforma was used to record
the details of observation made in the cases of Postmortem lividity was seen over the
hanging in the present study. The information back of the body in 41 (93.18%) cases.
thus collected, was tabulated using Statistical In present study, Peri ligature injuries
Package for Social Sciences (SPSS) software, like rope burns (93.18% of cases) followed
IBM manufacturer, Chicago, USA, version by Cyanosis of fingertips and nail beds of
21.0 and results were thereby drawn. both hands (88.63 % cases) were one of the
commonest findings. Petechial haemorrhage
RESULTS
on face were observed in all partial hanging
During this study period, 306 cases were case. Pale, white, hard and glistening sub-
brought for post-mortem examination out cutaneous tissue underneath the ligature
of which 44 (14.38 %) deaths were due to marks were noticed at autopsy in all cases.
hanging. 3/4th of the victims were females. Pulmonary edema was observed in 42 cases

Table 1: Typical and Atypical hanging

Position of knot
Typical / Atypical Back Left Right Total (n=44)
Typical 8 - - 8(18.19%)
Atypical - 23 13 36(81.81%)
8(18.19%) 23(52.27%) 13(29.54%) 44

Table 2: Type of Hanging (Complete / Partial) Table 3: According to the Level of the Ligature Mark
Level of ligature mark Cases Percentage
Type of Hanging Number Percentage
Above the thyroid cartilage 38 86.36
Complete 12 27.28
Below the thyroid cartilage 2 4.55
Partial 32 72.72
Overriding the thyroid cartilage 4 9.09
Total 44 100.0 Total 44 100
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and congestion of lungs were noticed in all 32.31% cases with dribbling of saliva. Absence
the cases. Other classic signs of asphyxia were of hyoid bone and thyroid cartilage fracture in
absent in majority of complete suspension of any of the cases was inconsistent with a few
victims’ bodies. studies.2,6,7,8,9,10,12
Postmortem lividity was seen over the
DISCUSSION back of the body in majority of the victims’
During this study period, 306 cases were points to the fact that the body was removed
brought for post-mortem examination out of from suspension within a few hours and
which 44 (14.38 %) deaths were due to hanging. placed in a prone position.
75% of the victims were females. Domestic These internal findings at autopsy with
and work-related issues, bereavement, failure regards to signs of asphyxia was found to be
in love along with easy accessibility of ligature consistent with a few literature studies. 13,14
material in a private setting may be the cause
for the female predominance.
CONCLUSION
In our study, atypical hanging (81.81%) Precise understanding and interpreting of
was commonly noticed over typical hanging autopsy findings in hanging cases is of utmost
(18.19 %). In over half of the victims’ cases, importance in making an assertive diagnosis
Knot was on the left side of neck. Similar of death owing to hanging. Our current study
findings were observed in the studies conducted showed that the findings in different types of
by other authors. 1, 2,11 The form of knot and hanging could differ, from time to time with
completeness of hanging are important in exceptions to the largely accepted. Awareness
determining the ligature mark over the neck. of these combinations of findings are of
In the present study, partial hanging was vital importance in coming to an inference
more commonly observed in comparison in a suspected case of hanging to avoid any
to complete hanging which was reported in inaccurate opinion.
approximately 1/4th of the deaths. This is in
Conflict of Interest: Nil
concurrence with studies by some authors
1,2
but not in agreement with a few others. Ethical Clearance: Obtained
3,4,12,15
This could be due to regional influence, Source of Funding: Self
multiple medical colleges being under the
same jurisdiction of the police stations,
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