Korean J Leg Med.  2019 Aug;43(3):106-110. 10.7580/kjlm.2019.43.3.106.

A Complex Suicide by Ligature Strangulation and Hanging Using Two Different Ligatures

Affiliations
  • 1National Institute of Forensic Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia. kuna0921@yahoo.com
  • 2Department of Forensic Medicine, Hospital Pulau Pinang, George Town, Malaysia.

Abstract

Hanging is the most common method of suicide in Malaysia. However, hanging in combination with suicidal ligature strangulation is uncommon. The victim is a 31-year-old man, with no previous medical or psychiatric disorders. He accomplished self-strangulation using a shoelace and hanging himself with a High-Definition Multimedia Interface cable. Three loops of a shoelace ligature were present around the neck. A single knot was present on the front, and a double knot at the back of the neck. Internal examination of the neck revealed small bilateral hemorrhages of the sternocleidomastoid muscles. No laryngeal cartilage or hyoid bone fractures were observed. No other evidence of injury was noted other than moderate pulmonary edema. The post-mortem toxicology results were negative. The cause of death was ascertained as neck compression due to ligatures. Scene assessment and post-mortem findings concur with suicide. This report describes an unusual case of suicidal ligature strangulation, in combination with hanging using two different ligatures.

Keyword

Hanging; Ligature strangulation; Post-mortem; Suicide

MeSH Terms

Adult
Cause of Death
Hemorrhage
Humans
Hyoid Bone
Laryngeal Cartilages
Ligation*
Malaysia
Methods
Multimedia
Muscles
Neck
Pulmonary Edema
Suicide*
Toxicology
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