Autopsy Analysis of Suicidal Hanging Cases at Dhaka Medical College

Abstract

Background: Hanging is one of the common methods of suicide in the world. The rate of suicide by hanging is increasing day by day in Bangladesh. Suicide by hanging is the act of intentionally killing oneself by suspension from an anchor point or ligature point (e.g., an over head beam or hook) by a ligature or jumping from a height with a noose around the neck. Hanging is a very simple method of suicide that does not require complicated techniques. The materials required are easily available, and a wide range of ligature can be used, so most of the people commit suicide by suspension from a height with a ligature around the neck.Objective: The objective of this study was to find out demography of hanging, its distribution according to age group, sex, common ligature materials used by victims, observed post mortem findings and in this way try to identify the causative factors and develop the preventive measures that are essential to reduce death due to hanging.Materials and method: A retrospective study was done on the basis of 3rd copies of postmortem reports preserved in the department of Forensic Medicine, Dhaka Medical College, Dhaka, Bangladesh for the period of 2 years, (from January 2008 to December 2009) with the permission of the autopsy surgeons.Results: Out of 574 cases, 159 (27.71%) were male and 415 (72.29%) female. Among them 304 (52.96%) were married and 270 (47.04%) were unmarried. Most of the victims (46.86%) were from the age group 21-30 years. Dopatta (orna) was the commonest (41.28%) ligature material.Conclusion: To reduce the number of suicide by hanging a well designed and comprehensive programme is needed, which will identify the causative factors and which might help in prevention of suicidal hanging.Delta Med Col J. Jan 2016 4(1): 9-12

Suicidal Death due to Hanging

“…20 Almost similar observations were made by a good number of authors. 12,13,18,19 In present study cyanosis of fingertips and nail beds of both hands was the commonest finding followed by pale, white, hard, and glistening subcutaneous tissue underneath the ligature mark and dribbling marks of saliva. These findings are the most important signs of asphyxia and are mentioned in every literature available.…”

“…In many other studies similar observations were documented. 10,12,13 Suicide data by WHO also mentions that suicide occurs throughout the lifespan and is the second leading cause of death among 15-29 year olds globally. 14 Worldwide suicide rate is higher in males.…”

A Forensic Analysis of Ligature Material in Suicidal Hangings

“…Most death were due to asphyxia by using different ligature material, one end of which was tied with the point of suspension inside the house or branch of a tree outside the house or other point, and another end encircled the neck with a knot using a chair or table or stool as the base for standing, later on push them away by feet [51]. In our study, the ligature material most commonly used for hanging was soft material in 64 (52.45%) cases and hard material in 58 (47.54%) cases.…”

“…However, the results of current study were close to the observations made by Morild [24] who reported complete suspension in 51 % cases, Cooke, et al [25] who noticed complete suspension in 41% cases, kneeling in 8%, sitting 8% and lying in 1% cases, Simonsen [26]wherein complete suspension was reported in 38 % cases, and Elfawal and Awad [27]who observed complete suspension in 79% and partial in 21% cases. Similar observations were made by Meera and Singh [19] who observed complete hanging in 88.10% cases and partial in 8.33% cases, Patel et al [20] who noticed complete hanging in 98.75% cases and partial hanging in 1.25% cases, Kumar, et al [32], wherein nature of suspension was complete in 88.32% cases and partial in 11.68% cases, Ahmed, et al [41] wherein complete suspension was observed in 82.23% cases and partial hanging in 17.77% cases, Rahman, et al [51] who observed 83% cases of complete hanging, Der, et al [65] who found complete hangings in 98.6% cases, and Singh et al [66] wherein complete hanging was noticed in 68.57% cases. While authors from other country like Charoonnate, et al [67] observed higher number of incomplete hanging cases (55%) as compared to complete hanging cases (45%) in a study at Thailand.…”

Distinguishing between homicide and suicide knots and ligatures: A comparative analysis of case and survey data

“…Suicide methods can differ from culture to culture depending on social acceptability, the availability of suitable materials, and the technical means to perform the act [25–47,70–73]. Some suicides are extremely unusual and ostensibly equivocal [1–6,13–20].…”