Homicidal Asphyxia

Abstract

Homicides due to asphyxia are relatively uncommon. To better understand the presentation of such cases, the files of the Bexar County Medical Examiner's Office were reviewed from January 1, 1985, through December 31, 1998, for all such homicides. A total of 133 cases were found. The largest category was ligature strangulation with 48 deaths (21 male, 27 female). Petechiae were present in the conjunctivae and/or sclerae in 86% of the cases; fractures of the hyoid and/or thyroid cartilage were present in 12.5%. There were a total of 41 deaths from manual strangulation (27 female, 14 male). Petechiae were present in 89% of the cases. In cases of manual strangulation, fractures of the hyoid, thyroid, or cricoid cartilage were found in all the male victims and slightly more than one half of the female victims. Twenty-six cases of suffocation were found; 20 of the victims were < or =2 years of age. Only 1 of these children had petechiae and/or scleral hemorrhage. Five deaths were due to choking. Three of the deaths involved adults who were gagged; 2 deaths involved infants with foreign material pushed into the mouth. Other categories of asphyxia were as follows: 9 deaths due to more than one form of asphyxia; 1 death due to hanging, and 3 deaths due to drowning. Rape was the motive in 66% of the female victims of ligature strangulation and 52% of those due to manual strangulation.

Injuries due to Asphyxiation and Drowning

“…For example, there have been cases of small children falling onto low, taut ropes resulting in death by hanging (Flobecker et al 1993). Extremely rare cases have been reported of homicidal hangings as foul play (Böhmer 1940;DiMaio 2000). In some countries, hanging is still a method of execution.…”

“…Where the ligature is knotted at the back of the neck, foul play must be suspected. In many cases, external intervention is immediately evident because fatal and non-fatal ligature strangulation frequently involves other traumatic violence (Haarhoff 1971; majora of the hyoid bone less so (Haarhoff 1971;Maxeiner 1990;DiMaio 2000). Fractures of the thyroid cartilage plate and the cricoid cartilage are rare; however they occur more frequently in manual strangulation than in ligature strangulation.…”

Difficulty in Swallowing Due to Attempted Manual Strangulation

“…Tanısal açıdan önemi ise sıklıkla laringeal kı-kırdak mikrofraktürleri kanamaya eşlik etmektedir. Bağla boğ-ma olgularının çoğunluğu oluşturduğu 133 olguluk otopsi incelemesinde olguların % 86'sında konjunktiva ve/veya sklerada peteşiler saptandığı, ancak olguların sadece % 12,5'inde hyoid kemik ve/veya tiroid kıkırdakta fraktür görüldüğü bildirilmiştir [7]. Hyoid kemik kırığının elle boğma olgularında ası ve bağla boğ-ma olgularına göre daha fazla sıklıkta görüldüğü, fakat elle boğ- ma olgularında bile olguların ancak % 34'ünde kırık saptandığı bildirilmiştir [8].…”

Boğucu Gaz Soluma Yoluyla İntihar Olgu Sunumu

“…‹ntihara ba¤l› asfiksi s›kl›kla as› ya da suda bo¤ulma sonucu meydana gelmekte ise de bo¤ucu gaz kullan›m› sonucu meydana gelen ölümlere de nadiren rastlanmaktad›r (12)(13)(14). Geçmiflte evlerde yayg›n olarak kullan›lan havagaz›, ulafl›lmas›n›n kolay olmas› nedeni ile intihar…”

“…Oysa kullan›lm›fl olan tüpgaz üretici firmas›ndan al›nacak kompozisyon bilgileri ve yap›lacak olan gaz kromatografik analizde elde edilecek gaz komponent verileri karfl›laflt›rmas›yla bu olguda daha objektif verilere ulafl›labilece¤i literatür örnek-lerinde bildirilmektedir (9,(12)(13)(14).…”