Clinicopathologic Features of Fatal Self-Inflicted Incised and Stab Wounds

Abstract

The files of the Forensic Science Center in Adelaide, South Australia, were examined for all cases listed as suicide in which death had been caused by the use of a sharp instrument during the 20-year period from January 1981 to December 2000. Fifty-one cases were identified, consisting of 35 men and 16 women. The age range was 23 to 83 years (mean 49 years) representing 1.6% of total suicides (513182). Fatal injuries included incised wounds to the arms in 51.4% of men (n = 1835) compared with 87.5% of women (n = 1416), incised and stab wounds to the neck in 40% of men (n = 1435) and 25% of women (n = 416), and stab wounds to the chest or abdomen in 28.6% of men (n = 1035) and 12.5% of women (n = 216). In 8 cases, multiple sites were involved. The use of sharp instruments in suicide was favored by older, rather than younger, individuals, with a tendency for women to incise their wrists. Hesitation marks were present in 23 cases (54%) and scarring of the wrists from previous suicide attempts in 5 cases. Although this study demonstrated a higher number of men than women committing suicide by using sharp objects, this method of suicide remains uncommon.

Evaluation of manner of death determination parameters in deaths related to sharp force injury

“…İntiharlarda el bileği ve kollarda, cinayetlerde göğüs ve üst ekstremitede daha sık yaralanma görüldüğü bildirilmekte (21,33), ayrı-ca gövde ön yüz, boyun ve ön kollarda yer alan yaralanmaları ağırlıklı olarak intiharı; kafa, kol, el, ense ve vücut arka yüzde tespit edilen kesici alet yaralanmaları ise cinayeti düşündürmektedir (7,11,12,18,33,42). Ayrıca boyundaki kesici alet yaralanmaları tek taraflı ise intiharı, çift taraflı ise cinayeti akla getirmektedir (16).…”

Atypical stab injury suggesting ritual suicide

“…Although suicidal blade injuries are encountered at autopsies quite often (representing approximately 2-3% of all suicides [2,[8][9][10]), suicidal stabbing remains rarer. From a medicolegal point of view, the main problem in sharp force fatalities that must always be answered is the determination of the manner of death [9,11,12].…”

“…a weapon at the place of death, tentative wounds, defensive injuries, removal of clothing, etc.). The more indicators that are Archiwum Medycyny Sądowej i Kryminologii Archives of Forensic Medicine and Criminology [2,[8][9][10]), jednak urazy zadane poprzez ugodzenie są zjawiskiem rzadszym. Z sądowo-lekarskiego punktu widzenia podstawowym problemem w urazach zadanych ostrym narzędziem jest ustalenie rodzaju śmier-ci [9,11,12].…”

“…W wielu badaniach autopsyjnych wykazano, że w samobójstwach dokonywanych poprzez wbicie ostrego narzędzia samobójca wybiera łatwo dostępny obszar, tj. kończyny górne i te części ciała, w których zlokalizowane są narządy niezbędne do życia i któ-rych uszkodzenie prowadzi do szybkiej i relatywnie bezbolesnej śmierci [10]. W związku z tym samoobrażenia zadawane ostrym narzędziem są najczęściej umiejscowione w rejonie szyi, serca i jamy brzusznej.…”

Kesici ve Kesici Delici Alet ile İntihar İki Olgu Sunumu

“…Karger ve arkadafllar› taraf›n-dan derin yaralanma gösteren iki adet kesici-delici alet ile intihar olgusu bildirilmifl, ilk olguda bir kad›n gö¤süne b›çak saplay›p kendini yata¤›n üzerine atm›fl, vücudu-nun arka k›sm›ndan b›ça¤›n ucu ç›km›fl, di¤er olguda ise bir erkek gö¤süne b›ça¤› saplad›ktan sonra tu¤la ile çak-m›flt›r (9 ölüm olgusu yay›nlam›fl (15), Meade ve arkadafllar› 1993 y›l›nda boyunda vena jugularis interna kesisi oluflturan, 3 b›çak darbesi ile sol akci¤erde 500 ml, sa¤ akci¤erde 100 ml kanamaya yol açan bir olgunun, 100 metre ileride as› yöntemi ile intihar etti¤ini bildirmifllerdir (16). Byard ve arkadafllar› 2002 y›l›nda Güney Avustralya'da 20 y›l süre-since meydana gelen 51 kesici alet yaralanmas›na ba¤l› intihar olgusunu incelemifl, tüm intiharlar›n % 1,6's›n›n kesici aletlerle yap›ld›¤›n›, yaralanmalar›n erkeklerde %51,4, kad›nlarda %87,5 oran›nda kol bölgesine, erkeklerde %40, kad›nlarda %25 oran›nda boyun k›sm›na; erkeklerde %28,6 kad›nlarda %25 oran›nda gö¤üs ve kar›na yönelik oldu¤unu, yafll›lar ve kad›nlarda bile¤e uygulanabildi¤ini ifade etmifllerdir (17). Gill ve Catanese 2002 y›-l›nda yay›nlad›klar›, 120 olguluk kesici alet yaras› serisinden 17'sinin intihar orijinli oldu¤unu, intiharlar›n yar›-s›ndan fazlas›n›n banyoda gerçeklefltirildi¤ini, %24 intihar olgusunda intihar notu oldu¤unu belirtmifllerdir (18).…”