Hanging-delayed death (a rare phenomenon)

Post-obstructive Pulmonary Oedema in Delayed Death by Hanging: A Case Report

Hanging is a common method to attempt suicide, which is highly lethal and results in immediate death. Near-hanging refers to those who survive a hanging injury and are able to reach a hospital. Only a few survive such episodes if they are promptly rescued, but they usually die later, which is called delayed death by hanging. Post-obstructive pulmonary oedema is a fatal complication that occurs after the removal of severe upper respiratory tract obstruction. Post-obstructive pulmonary oedema developing in delayed hanging death is not widely reported in the literature. Herein, we describe a case of post-obstructive pulmonary oedema in a 16-year-old girl with a history of attempted suicide by hanging.

Neuropsychiatric sequelae of attempted hanging and diagnostic dilemmas

Suicide is an important cause of death worldwide, and India is not immune to this major health problem. Suicide by hanging is one of the lethal methods widely practiced. However, literature is very sparse as well as old in the context of neuropsychiatric consequences seen in those who survive such attempts. We present a case of a young boy who survived an attempted hanging and was left with neuropsychiatric sequelae in the form of retro/anterograde amnesia, aggression, lability of affect, and impaired memory and visuomotor deficits. The associated diagnostic dilemmas, namely whether to diagnose such patients with Korsakoff's psychosis, organic amnesic syndrome, or major neurocognitive syndrome, are discussed and a brief review of literature of this largely ignored area is also presented.

Ingestion of safety razor blade and delayed hanging in a complex suicide

Ingestion of a foreign body is mostly accidental in children and intentional in prisoners to achieve hospitalization; however, use of this method of suicide is rare. We report a case where the victim first ingested a safety razor blade, but failed to die and then hanged himself, but failed again and finally succumbed to the complications on the sixth day. He had also attempted suicide by inflicting multiple incised wounds on his neck four days before the safety blade ingestion, but none were fatal.

Course of Near-hanging Victims Succumbed to Death: A Seven Year Study

INTRODUCTION

Near hanging refers to victims who survive a hanging injury following attempted hanging, long enough to reach hospital. Delayed deaths in near hanging patients are mostly due to complication of hanging. The purpose of this study was to evaluate the demographics, mortality patterns and cause of delayed deaths in near hanging victims.

MATERIALS AND METHODS

In this study autopsy files over a seven year period from 2007 to 2013 were reviewed, and data of near hanging deaths (attempted hanging cases who succumbed to death and subjected for medicolegal autopsy) was extracted. Records of 14,000 autopsies was reviewed, and 10 deceased having died delayed deaths after near hanging episode were identified. In each case, the patients' details, including gender, age, type of suspension, type of ligature material used for hanging and subsequent hanging mark produced were reviewed using autopsy reports and photographs taken during autopsy.

RESULTS

Demographic and pathological aspects of the each case discussed to throw light on autopsy findings in victims who died following near hanging. Complete suspension was present in 3 cases, while partial suspension was present in 7 cases. Survivals in delayed death after near hanging episode have ranged from 9 h to 72 d. Hypoxic encephalopathy was the most common cause of death, followed by pneumonia.

CONCLUSION

Most of the near hanging patients did succumb to hypoxic encephalopathy; however, consolidation of lungs (pneumonia) was the next common cause of death reflecting need for aggressive oxygen therapy and selective resuscitation should be performed in all such cases.

Computed tomography and magnetic resonance imaging findings of brain damage by hanging

We reported computed tomography (CT) and magnetic resonance imaging (MRI) findings of brain damage of a 61-year-old man who attempted suicide by hanging. Unenhanced CT demonstrated multiple hyperdense areas indicating subcortical and subarachnoid hemorrhages and brain swelling. MRI demonstrated not only hemorrhagic findings, but also ischemic findings in the middle brain and cerebral cortex. Multifocal cerebral hemorrhages might be caused by venous hypertension due to compression of the jugular veins.