Newer trends in hanging death.

A total of 105 cases of deaths due to hanging were studied in a span of 5 years time. This present study throws some light on the emerging trends that Hanging is increasingly being adopted by a relatively younger age group who are mostly illiterate and of poor socio-economic status. Hanging being viewed as giving swift painless death and without much expenses and without arousing much suspicion, this mode is increasingly adopted to commit suicide. Dribbling saliva mark, which was a hallmark of Ante-mortem hanging, is increasingly seen in less number of cases. No incidence of fracture of Hyoid bone being seen in this study, due to the fact that most cases were of lower age group and also may be due to most of the victims adopting soft ligatures and low suspension points. Transverse tears in the Carotid arteries were not seen here and on subjecting to Histo-pathological study, we could detect disruption of intimal layer of Carotid artery. Effect of pressure on layers of skin were seen on Histo-pathological study showing vital reaction changes useful for labelling Ante-mortem hanging.

Nomenclature for knot position in hanging A study of 200 cases.

Hanging is one of the common methods of committing suicide world wide. Position of the knot, in hanging cases is important as it determines the post-mortem findings of the head and face and can also be used to predict the expected autopsy findings. Although hanging has been described in forensic literature since ages, there has been no proper scientific nomenclature for classifying the position of knot in hanging cases. This paper describes a new nomenclature of exact knot position on the neck based on commonly used anatomical landmarks with self explanatory terms of classification, so that it can be understood and used by the autopsy surgeons and the pathologists with ease. In the present study 200 cases of hanging were studied retrospectively and position of knot is classified according to a newly described nomenclature. The new nomenclature classifies the position of knot into 6 major classes each of which are further subdivided into 3 subcategories thus making 18 different positions on each side of neck. The most common position of knot was found at occipitomastoid region (32%) and the least common position being at mental region (2%).

Protocolo de cirugía selectiva en traumatismos penetrantes de cuello / Protocol of selective surgery in penetrating traumatisms of neck

Antecedentes: Los protocolos de exploración sistemática y selectiva de las heridas cervicales tienen similares cifras de morbilidad. Objetivos: Analizar los resultados de un protocolo de explotación selectiva en los traumatismos penetrantes de cuello. Lugar de aplicación: Hospital Público Municipal. Diseño: Retrospectivo. Población: 46 pacientes tratados desde mayo de 1989 hasta mayo de 2004. Método: Atención inicial según normas ATLS. Clasificación topográfica (Roon). Clasificación según la modalidad del traumatismo. Clasificación en grados de severidad de 1 a 4. Exploración inmediata en casos de heridas transfixiantes, hemorragía externa, hematoma, asfixia, estridor laríngeo, esfisema subcutáneo, aerorragia, hemoptisis o hemorragia intratorácica. Zona I: Considerar abordaje combinado. Zona I y II o compromiso neurológico: ecodoppler color o angiografía preoperatoria. Pacientes estables asintomáticos: conducta expectante, radiografía de columna cervical perfil, internación, tránsito faringoesofágico, endoscopias, etc. Lesión ósea o compromiso neurológico: Tomografía computada o Resonancia magnética. Contraindicamos estudios complementarios en pacientes inestables. Resultados: Heridas de arma de fuego: 29 (63%); heridas de arma blanca 14 (30,4%); heridas accidentales: 3 (6,5%). Cervicotomía exploradora inmediata: 21 casos (45,65%). Cervicotomía exploradora luego de observación inicial: 4 casos (8,7%). Exploración con anestesia local: 12 casos (26%). Observación y alta: 9 casos (19,5%). Mortalidad: 2 casos (4,34%). Cervicotomías negativas: 2 casos (4,34%). Morbilidad: 8 casos (17,4%). Conclusiones: Se obtuvieron resultados similares a protocolos selectivos que proponen la exploración de todas las lesiones de zona II, con un bajo porcentaje de cervicotomías no terapéuticas.