Korean J Leg Med.  2020 Aug;44(3):123-128. 10.7580/kjlm.2020.44.3.123.

Unusual Asphyxia: Two Autopsy Cases Report

  • 1SJS Institute of Forensic Science & Medicine, Suwon, Korea
  • 2Forensic Medicine Division, National Forensic Service Daejeon Institute, Daejeon, Korea


Asphyxia is primarily observed in either suicide or homicide. We encountered two unusual autopsy cases, which were extremely rare and atypical, with respect to the manner or cause of death. The first victim demonstrated external findings of a transverse ligature mark around his neck and foreign material in the form of flour or kneaded flour in the whole airway, including the oral and nasal cavity. Based on the scene investigation images and autopsy findings, we identified that the victim attempted to strangle himself with a necktie first, but failed. He then inhaled flour and suffocated. The second victim, who died while sleeping, had a transverse ligature mark around her neck with marked facial congestion, multiple petechia of the conjunctiva and oral mucosa, and extensive hemorrhage of the neck muscles. Police investigation found the deceased stuck in a massage machine without the protective cover that prevents small objects being sucked into the machine. Her death was ruled to be accidental. We present two unusual cases of asphyxia, discuss the mechanism of asphyxia in each case, and review the literature.


Asphyxia; Unusual asphyxia; Autopsy
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