Injuries due to Asphyxiation and Drowning

Keil, W.; Lunetta, Philippe; Vann, RD; Madea, Burkhard

doi:10.1002/9781118570654.ch21

Cited by 9 publications

(14 citation statements)

References 173 publications

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“…Conjunctival and cutaneous petechiae were noted in almost two‐thirds of all the victims. In contrast to earlier observations (10,20) they were slightly more common in strangulation cases involving ligature than in strangulations performed by hands only. There was no diagnostic difference in the presence of lingual hemorrhages that were observed in approximately one‐fifth of the cases in both manual and ligature strangulations.…”

Section: Discussioncontrasting

confidence: 99%

“…In manual strangulations, a hyoid bone fracture was the most common finding, followed by a fracture of a single thyroid horn. In ligature strangulations, one‐fifth of the victims presented a fracture of a single thyroid horn and in one‐seventh of a hyoid bone, which is usually a rarer finding according to the literature (20). Bilateral fractures to the superior horns of the thyroid cartilage were observed in approximately one in ten cases and were slightly more common in manual than in ligature strangulation victims.…”

Section: Discussionmentioning

confidence: 99%

“…The pathological features of asphyxia are extensively described in the forensic medicine literature (18,19,20), and the frequent, albeit nonspecific, findings include cervico‐facial congestion. In cases with cervical compression external neck injuries, conjunctival, and facial petechiae (21), hemorrhages of the tongue, hemorrhages in soft tissues of the neck, and fractures in hyoid bone and/or thyroid cartilage are typical findings.…”

Section: Discussionmentioning

confidence: 99%

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Asphyxia Homicides in Finland, 1983–2012

Wahlsten

Eriksson

2020

Journal of Forensic Sciences

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Finland has one of the highest homicide rates in Western Europe, and almost every tenth homicide is caused by asphyxiation. Reliable statistics, a strict legislation, and an exceptionally high medico‐legal autopsy rate formed a base for a nationwide analysis of asphyxia homicides (n = 383) during 30 years. The cases were identified through multiple records, and all the forensic pathology case files were studied in detail. In more than one out of five cases, there were indications of staging, and the homicide was revealed first at autopsy in close to one in ten cases. The vast majority of the homicides took place in private locations and involved persons known to each other. Every third victim was an intimate partner, and every tenth a child. Almost half of the victims died from manual strangulation, one in three from ligature strangulation. Smothering, choking, neck compression with a firm object, and thoracic compression were more rare methods. Drownings were excluded from this study material. Of all the victims, 7% had no observable external injuries. Petechiae were recorded in approximately in 61%, laryngohyoid fractures in 47%, and vocal cord hemorrhages in 16% of the cases. Every tenth female victim had genital injuries. Toxicological analyses were performed in close to all of the cases, and almost three out of four victims tested positive for blood alcohol. The various aspects of the demographics and autopsy findings covered in this study contribute reliable and accurate data to further strengthen the spectrum of observable medico‐legal characteristics of asphyxia homicides.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Asphyxia Homicides in Finland, 1983–2012

Wahlsten

Eriksson

2020

Journal of Forensic Sciences

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“…“Asphyxia” or “asphyxiation” is defined as an oxygen deficit caused by specific traumas resulting in hypoxic-ischaemic brain damage and death. These traumas include various mechanisms, such as strangulation, obstruction of respiratory movements and obstruction of the respiratory orifices and/or the airways [ 1 ]. Asphyxia also occurs as strangulation of elderly or psychotic persons who become trapped in bed [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Entrapment within an ottoman storage bed: an unusual accidental asphyxial death

Cinquetti

Franchetti

Fichera

et al. 2022

Forensic Sci Med Pathol

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Herein, we present an uncommon forensic case of death by asphyxia. The victim was a woman whose body at death scene investigation (DSI) was discovered beside an ottoman storage bed. According to the rescue team, who had moved the body before our arrival, the body was originally found in the prone position and stuck with the neck, thorax and arms within the bed. Examination of the body showed hypostasis that was mainly distributed to the face and the lower chest while sparing the neck and the upper chest. The face was markedly swollen, and the eyes were congested with blood. Dissection and histology revealed pulmonary oedema and emphysema of both lungs. Integrating circumstantial, radiology and autopsy data, it was established that the victim, while trapped between the mattress and the edge of the ottoman storage bed, died by mechanical asphyxia due to cervical-thoracic compression and postural asphyxia acting simultaneously.

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“…Although Rasmussen et al [5] described petechial hemorrhages of the tympanic membrane in attempted suicide by hanging, we did not find reports of intravital otorrhagia in cases of hanging. Hanging may be complete—when there is no contact between the feet and the floor and full suspension is achieved, or incomplete, when suspended body has some form of contact to the ground (usually with the feet, more rarely other parts of the body), so that only part of the body weight is pressing on the neck region (partial suspension) [6]. In typical hanging, the knot or the highest point of the ligature is at the back of the neck, while in atypical hanging, the position of the knot or the highest point is elsewhere—in the anterior or lateral side of the neck [7].…”

Section: Introductionmentioning

confidence: 99%

Otorrhagia as an intravital phenomenon in a case of incomplete atypical hanging

Živković

Cvetković

Nikolić

2020

Journal of Forensic Sciences

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Herein, we describe a case of an 81‐year‐old woman who was found hanged in the kneeling position, at the height of about 1.3 m, with anterior position of the knot. There were two downward directed stripes of dried blood coming out of the left nostril and left ear, while the right ear was filled with a small pool of blood. Since the hanging occurred in the kneeling position with the head “on top,” it is likely that the anterior position of the knot, with only (partial) weight of the head pulling the noose, resulted in complete obstruction of the venous flow, but only partial obstruction of the arterial flow, probably including both carotid and vertebral arteries. The venous pressure rise was not caused by the position of the head, meaning that it required a “pump,” that is, preserved circulation and heart function. The first finding that speaks in favor of this mechanism is the small pool of blood in the right external auditory canal, since its position is completely antigravitational. The second one, even more convincing, is the finding of the so‐called trout phenomenon, that is, petechial bleeding on upper and lower eyelids and on the skin between the eyebrows, because this phenomenon requires impaired or obstructed venous return in the presence of continued arterial input. We can conclude that in this case of atypical, incomplete, suicidal hanging, otorrhagia was a vital reaction.

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Injuries due to Asphyxiation and Drowning

Cited by 9 publications

References 173 publications

Asphyxia Homicides in Finland, 1983–2012

Asphyxia Homicides in Finland, 1983–2012

Entrapment within an ottoman storage bed: an unusual accidental asphyxial death

Otorrhagia as an intravital phenomenon in a case of incomplete atypical hanging

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