title: A Study of Fatal and Nonfatal Hangings.
abstract: Approximately 50% of all suicides performed worldwide are strangulations. This article presents options for the medicolegal examination of hanging. The pathogenetic mechanisms and clinical pictures of victims are discussed. Examples of the process of diagnosis and expert conclusions are given. This article is intended for physicians and forensic pathologists. The literature focusing on asphyxia by strangulation is reviewed. Data from Vilnius Hospitals and the State Forensic Medicine Service concerning strangulations performed between 2012 and 2014 are analyzed and include the findings of 5650 autopsies (36% asphyxia) and 4 survived victims. The predominant symptoms were neurological, cardiovascular, and respiratory symptoms. After asphyxia, patients should consult by a psychiatrist, ophthalmologist, gastroenterologist, and endocrinologist. A ligature mark was the most observable sign of asphyxia by neck strangulation. Only complications in the poststrangulation period were treated. Mechanical asphyxia must be identified as the main injury in the clinical diagnosis and encoded as ICD-10.
authors.affiliation: Faculty of Medicine, Department of Pathology, Forensic Medicine and Pharmacology, Vilniaus University, M. K. Ciurlionio str. 21, Vilnius, Lithuania.
authors.forename: Gerda
authors.initials: G
authors.lastname: Andriuskeviciute
authors.affiliation: Faculty of Medicine, Department of Pathology, Forensic Medicine and Pharmacology, Vilniaus University, M. K. Ciurlionio str. 21, Vilnius, Lithuania.
authors.forename: Sigitas
authors.initials: S
authors.lastname: Chmieliauskas
authors.affiliation: Faculty of Medicine, Department of Pathology, Forensic Medicine and Pharmacology, Vilniaus University, M. K. Ciurlionio str. 21, Vilnius, Lithuania.
authors.forename: Algimantas
authors.initials: A
authors.lastname: Jasulaitis
authors.affiliation: Faculty of Medicine, Department of Pathology, Forensic Medicine and Pharmacology, Vilniaus University, M. K. Ciurlionio str. 21, Vilnius, Lithuania.
authors.forename: Sigitas
authors.initials: S
authors.lastname: Laima
authors.affiliation: Faculty of Medicine, Department of Pathology, Forensic Medicine and Pharmacology, Vilniaus University, M. K. Ciurlionio str. 21, Vilnius, Lithuania.
authors.forename: Dmitrij
authors.initials: D
authors.lastname: Fomin
authors.affiliation: Faculty of Medicine, Department of Pathology, Forensic Medicine and Pharmacology, Vilniaus University, M. K. Ciurlionio str. 21, Vilnius, Lithuania.
authors.forename: Jurgita
authors.initials: J
authors.lastname: Stasiuniene
mesh_terms: D001237:Asphyxia; D001344:Autopsy; D003288:Contusions; D005554:Forensic Medicine; D006801:Humans; D019838:Neck Injuries; D013405:Suicide
keywords: forensic science; ligature mark; neck strangulation; poststrangulated period; primary injury; vagal reflex