External examination in hanging cases.pptx

This PowerPoint presentation provides a comprehensive overview of the external examination in hanging cases through the detailed analysis of five distinct case studies. Each case study showcases a different mode of hanging and varying outcomes of death, offering a thorough understanding of the complexities involved in such investigations.
This presentation aims to enhance understanding of the forensic processes involved in hanging cases, highlighting the importance of meticulous external examinations to accurately determine the cause and manner of death.

1. EXTERNAL EXAMINATION IN HANGING CASE by : Pushkar choudhary

2. INTRODUCTION Hanging is that form of asphyxia which is caused by suspension of the body by ligature which encircles the neck. The constriction force is being the weight of the body. Hanging may be partial or complete depending on the position or posture of the body at the time of hanging. Hanging is a common method of suicide around the world. In India hanging is among the top 5 methods of choice for committing suicide. The typical external findings that should be looked for in a case of hanging death are the ligature mark, knot position, color of the face, frothing, glove and stocking pattern of post-mortem lividity , dribbling of saliva, tongue position, eye open or closed, dilated pupil etc. All these have immense importance in concluding the various objectives of autopsy

3. 1. SIGNIFICANCE OF EXTERNAL FINDINGS IN HANGING CASES DURING AUTOPSY   The external findings are utmost important in the opinion formation during autopsy of hanging deaths. Thus the current study was done with the aim of studying the significance of external findings in hanging cases during post-mortem examination. Material and methods : The present study was carried out in the Department of FMT, RIMS, Ranchi prospectively from 1st March, 2013 to 30th May, 2014. The materials for the present study were dead body brought for autopsy from various police stations. Cases which died due to asphyxia as a result of hanging either alone or in association with other injuries are included for the study. Result and discussion : Majority of cases of hanging had not received any treatment. In maximum cases the nature of suspension was complete type. A typical hangings were seen in most cases. Most commonly used ligature materials were Jute Rope and Dupatta . In majority cases the ligature mark was above the thyroid cartilage followed by at and above the thyroid cartilage. In maximum cases the position of knot was present at occipital region of the neck, followed by at over left mastoid region of the neck. In majority of case the ligature mark was prominent and discontinuous. The colour of ligature mark was dark brown in more than half of the cases followed by yellowish brown. In majority of cases the post-mortem staining was present. Only about 39% of cases the dried salivary stain was found. Involuntary discharge was seen only in 17% of cases. Tongue protrusion was found in 29.87 % of cases. Conclusion : A keen external examination is mandatory before proceeding towards the dissection of the dead body in hanging cases during post-mortem examination. Certain important objectives of autopsy may be achieved from such external study like manner, time since death/injury or survival period, position of body, type of suspension, antemortem or post-mortem nature, type of ligature material used etc. Niranjan Sahoo1 , Nityanand Kumar2 , Bibhuti Bhusana Panda*1 and Arunava Dutta2

4. 2. PATTERN OF EXTERNAL AND INTERNAL FINDINGS IN DEATHS OWING TO HANGING—A STUDY IN NORTHEAST DELHI Materials and Methods: A total of 101 cases of hanging were examined during autopsy. The details about the victims with regard to the age, sex, and type of ligature material and autopsy findings were noted. The data thus obtained were analyzed for the study. Result: A total of 101 cases of hanging were studied during November 2009 to February 2011, of which 43.56% of cases were in the age group of 21–30 years, and 68.31% were male subjects, single mark was seen in 95.04% cases, incomplete ligature was found in 99% cases, chunni was the commonest (37.70%) ligature material used, the knot was on the right side of neck in 45.60% of cases, and fixed knot was found in 68.85% of cases. Fracture of hyoid bone was found in 5.94% of cases, and that of thyroid cartilage was found in 4.95% of cases; salivary stains were found in 66.33% of cases; petechial hemorrhages were found in 11.88% of cases on external body surface and in 87.12% cases in internal body organs. Congestion of internal body organs were found in 96.03% of cases. Conclusion: In our study, findings in the cases of hanging varied and were found in many combinations. A correct interpretation of such findings and meticulous postmortem examination is necessary to make a confirmatory diagnosis of death owing to hanging.   Najan A Bhausaheb1 , Chinchole S Baburao2 , Kalyan Kumar Banerjee3 , Anil Kohli3

5. 3. HANGING CASE OF AN ADULT MALE: A CASE REPORT Case study : The case is reported as - Sohel Mahmud ( Tuhin )’s dead body was found hanged by ligature in neck in a washroom at the Motijheel Police Station. The ligature material used was nylon shoe lace. Etxernal examination proving the signs of hanging : 1. One ½ inch wide ligature mark was found in upper part of neck which was oblique & non-continuous with a gap of about 2 inch in left back side of neck. 2. The skin at ligaturesite was parchmentised . 3. There was dribbling of saliva from right angle of mouth to chest. Conclusion : Complete hanging is considered as suicidal in nature, (Whatever the site of occurance ) unless otherwise proved. Partial hanging is considered as suicidal , there is no second thought. In this case it was a case of complete hanging and the ligature material used was two pieces of nylon shoe lace which raised confusion that how hanging can be caused by shoe lace. But it is quite possible. A. Visible ligature mark Md. Rafiqul Bari1 , T. C. Das2 , Anwar Hussain3 , Md. Mazharul Islam4 , Abul Kalam Mohammad Yousuf

6. 4. POSTMORTEM NON-INVASIVE VIRTUAL AUTOPSY: DEATH BY HANGING IN A CAR Case study : A body was found behind a car with a noose tied around its neck, the other end of the rope tied to a tree. Apparently the man committed suicide by driving away with the noose tied around his neck and was dragged out of the car through the open hatchback. postmortem multislice -computed tomography (MSCT) and magnetic resonance imaging (MRI) indicated that the cause of death was cerebral hypoxia due to classic strangulation by hanging, and not due to a brainstem lesion because of a hang-man fracture as would be expected in such a dynamic situation. Results : External Examination: The tight noose around the neck resulted in a clearly visible ligature mark encompassing the whole neck circumference with abrasions located predominantly on the front side of the neck .No congestive haemorrhages were detected in the mucosal linings of the eyes, mouth and ears. Stephan Bolliger,1 M.D.; Michael Thali,1 M.D.; Christian Jackowski,1 M.D.; Emin Aghayev,1 M.D.; Richard Dirnhofer,1 M.D.; and Martin Sonnenschein,2 M.D. Figure 1.

7. Radiological Examination using MSCT/MRI: Based on cross-sectioned CT and MR technology, in our case the injury pattern to the neck was documented non-destructively and non-invasively (Figs. 3). MSCT sagittal reconstruction body. A MSCT 3D reconstruction of the cervical spine (Fig. 4a) documented the lack of osseous lesions further. But a fracture of the hyoid bone could be detected. Conclusion: It is concluded that MSCT and MRI are useful instruments with an increased value compared with 2D radiographs to augment the external findings of bodies when an autopsy is refused. But further postmortem research and comparing validation is needed.

8. 5. HANGING DEATH : CASE STUDY Report: A young male age about 26 years got married, a couple years back. He used to maintain his livelihood from the poor income being an auto-driver and used to pass hard days. His strained family relation also added misery to his life therefore he was unable to handle the pressure and committed suicide by hanging from branch of tree.

9. EXTERNAL EXAMINATION FINDINGS : The deceased was about 26-year-old, male, 1.62 m in height, 56 kg in weight and average built. The facial features were congested, soiled with dry mud, eyes were closed, and mouth was partially opened. The tongue was congested and protruded from between the teeth and lips. One brownish-black, grooved ligature mark of maximum width of 0.02 m was found present on front and both sides of the neck. The mark was directed obliquely upward towards back of the neck of deceased. Out of total 0.4 m neck circumference, the ligature mark was found to be absent for around 0.14 m at backside. Further, ligature mark was situated just touching the tip of left mastoid process, 0.06 m below the chin, 0.11 m above the suprasternal notch and 0.02 m below the tip of right mastoid process. Evidence such as the knot of the jute coil over the branch of tree fixed tightly was also found. Conclusion: The crime scene is a treasure of clues and proper examination of spot, collection of physical evidence and their evaluation could help to establish the real fact. Further, the autopsy findings and circumstantial evidence in the present case conclusively suggested suicidal hanging and ruled out the possibility of strangling and homicidal hanging.

10. REFRENCES 1. Sahoo , N. (2016). Significance of external findings in hanging cases during autopsy, International Journal of Biomedical and Advance Research 2016; 7(3): 119-122. 2. Bhausaheb , N. A., Baburao , C. S., Banerjee , K. K., & Kohli , A. (2015). Pattern of external and internal findings in deaths owing to hanging-a study in northeast Delhi.  Int J Med Sci Public Health ,  4 (11), 1536-1539. 3. Bari, M. R., Das, T. C., Hussain , A., Islam, M. M., & Yousuf , A. K. M. (2012). Hanging case of an Adult Male: A Case Report.  Journal of Dhaka National Medical College & Hospital ,  18 (1), 63-64. 4. Bolliger , S., Thali , M., Jackowski , C., Aghayev , E., Dirnhofer , R., & Sonnenschein , M. (2005). Postmortem non-invasive virtual autopsy: death by hanging in a car.  Journal of Forensic Science ,  50 (2), JFS2004070-6. 5. Pal, A., & Pratihari , H. K. (2017). Unusual Hanging-A Case Report.  J Forensic Crime Studies ,  1 (102), 1-5.