title: Retrospective analysis of 319 hanging and strangulation cases between 2001 and 2014 in Shanghai.
abstract: In this study, we retrospectively analyzed 141 cases of hanging and 178 cases of ligature strangulation recorded in the Shanghai Municipal Public Security Bureau between January 2001 and December 2014 to explore the characteristics of hanging and ligature strangulation and to supply a scientific reference for forensic pathology. Several significant differences between hanging and ligature strangulation were found. Hanging cases were mostly suicide, with some accidental cases. Strangulation cases were mostly homicide, with a few cases of suicide or sexual asphyxia. Male hanging was more common than female hanging, with a ratio of 5:2. However, there were more female than male strangulation cases, with a ratio of 13:5. The ligature marks in hanging cases were almost all of a "U" type and above the hyoid bone. The ligature marks in strangulation cases were almost always a closed circle, but the position varied. The most common vital reactions were subcutaneous hemorrhage, exfoliation and blister, which are strong evidence of antemortem injury. Hemorrhagic spots were found on the temporalis, scalp, chest and back in strangulation cases, but were rare in hanging cases. Hemorrhagic manifestations were most common in the sternocleidomastoid muscle in hanging cases, and in the sternohyoid and sternothyroid muscles in strangulation cases. Fractures occurred in only ∼17% of victims. There are notable differences between hanging and ligature strangulation, which can help distinguish between these causes of death. These characteristics should be considered in forensic practice.
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Shanghai, 200032, PR China.
authors.forename: Jianlong
authors.initials: J
authors.lastname: Ma
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Shanghai, 200032, PR China.
authors.forename: Haojia
authors.initials: H
authors.lastname: Jing
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Shanghai, 200032, PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zeng
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Shanghai, 200032, PR China.
authors.forename: Li
authors.initials: L
authors.lastname: Tao
authors.affiliation: Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, 803 North Zhongshan Road, Shanghai, 200082, PR China.
authors.forename: Yulei
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Forensic Lab, Criminal Science and Technology Institute, Shanghai Public Security Bureau, 803 North Zhongshan Road, Shanghai, 200082, PR China. Electronic address: makaijun@sina.cn.
authors.forename: Kaijun
authors.initials: K
authors.lastname: Ma
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, 131 Dongan Road, Shanghai, 200032, PR China. Electronic address: chenlong@shmu.edu.cn.
authors.forename: Long
authors.initials: L
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001237:Asphyxia / Q000401:mortality / Q000473:pathology*; D002648:Child; D002681:China / Q000453:epidemiology; D003490:Cyanosis / Q000473:pathology; D005260:Female; D006470:Hemorrhage / Q000473:pathology; D006708:Homicide / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000401:mortality / Q000473:pathology*; D009334:Neck Muscles / Q000473:pathology; D011693:Purpura / Q000473:pathology; D012189:Retrospective Studies; D017678:Sex Distribution; D012771:Shock, Hemorrhagic / Q000209:etiology; D013405:Suicide / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Hanging; Ligature strangulation; Mechanical asphyxia; Retrospective analysis