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54 Med. Sci. & L. 113 (2014)
Suspension without a Knot in the Noose

handle is hein.journals/mdsclw54 and id is 113 raw text is: Case report Suspension without a knot in the noose MD Nithin' and Smitha Rani' Medicine, Science and the Low 2014, Vol.54(2) 113-115 @ The Author(s) 2013 Reprints and permissions: sagepub.co.ul/journalsPermissions.nav DOI: 10. 1177/0025802413491248 msl.sagepub.com SAGE Abstract Most deaths by hanging are due to self-suspension. This may be carried out by a wide variety of methods, but a typical method of self-suspension is to attach a thin rope to a high point such as a ceiling beam. A 35-year-old woman committed suicide by hanging, where the ligature employed was not a typical knotted noose but instead an open iron chain anchored to the ceiling above. Keywords suicide, hanging, ligature material, knot, noose Introduction Suicide is the act of intentionally causing one's own death. Hanging is one of the 10 leading causes of death in the world, accounting for more than a million deaths annually.' In India, hanging is the second most common method of committing suicide after poison- ing.2 Hanging is a form of ligature strangulation in which force applied to the neck is derived from the gravitational drag of the weight of the body or part of the body.3 Hanging has been classified as typical or atypical depending upon the position of the knot in the noose. If a knot is present on the occiput it is designated an typical hanging - otherwise it is an atypical hanging.4 A method of suicidal hanging is usually carried out by attaching one end of a ligature material to a higher point such as ceiling beams, staircase, etc. and form- ing the other end into either a fixed loop or a slipknot which is placed around the neck. An absence of knot in the ligature on the neck, or complex tying of liga- ture material in hanging is rarely found.5 Herein, we present a case report of suicidal hanging without a knot in the noose. Case report We report a case of suicidal hanging where an adult woman aged about 35 years was found hanging from the ceiling of the house. The ligature material used was a twisted iron chain, which was a permanent fixture in the ceiling used to suspend the cane swing chair. The aforementioned ligature was used by the deceased in a U-shaped manner around the upper part of the neck, going behind the ear on both sides. The left hand of the deceased was up beside her face grasping the chain. There was no knot on the body of the deceased. There was a portable wooden chair in front of the victim and a portable plastic stool behind the victim. The feet were not touching the ground. The left hand might have been used to hold the chain in place. The height of the ceiling was about 12 feet from the ground (Figures 1 to 3). Autopsy findings The body was that of an adult woman, moderately built and nourished measuring 166cm in length and weighing 51 kg. Rigor mortis was present all over the body. Post mortem staining was present at the lower half of both the lower limbs with petechial haemor- rhages at places, consistent with history of suspension. The face was congested; there was no petechial bleeding. Evidence of bleeding was present at both the nostrils. Tongue was protruding out from the teeth and lips, dark brown in colour and bitten. A patterned, parchmented ligature mark was seen in front of the neck above the level of thyroid cartilage with clear indentations caused by the loops of the chain. The ligature mark was most prominent at the front of the neck and extending backwards and upwards behind both ears, measuring 34 cm in its entire length and 5 cm at its maximum breadth (Figure 4). The ligature mark was not seen at the back of the neck. Bloodless dissection of neck revealed haemorrhages under the periosteum of the 'Department of Forensic Medicine and Toxicology, J.S.S University, India Corresponding author: MD Nithin, Department of Forensic Medicine and Toxicology, J.S.S University, J.S.S. Medical College, Sri Shivarathreeshwara Nagar, Bannimantap, Mysore 570015, Karnataka, India. Email: nithin7755@gmail.com

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