Research article

Retrospective Study of Postmortem Cases of ‘Hanging – A Method Of Suicide’
Mohammed Ziyauddin G Saiyed, Kamesh A Modi
*Asst. Professor, Department of Forensic Medicine, GCS Medical college, Hospital & Research centre, Ahmedabad.
**Tutor, Department of Forensic Medicine, Smt. NHL Municipal Medical College, Ahmedabad.
Corresponding Author: Dr. Mohammed Ziyauddin G. Saiyed, 64, Nutan Gandhi Smriti Society, B/H Agro petrol pump, Juhapura Sarkhej Road,
Ahmedabad – 380055, Gujarat. dr_ziya_saiyed@yahoo.com

ABSTRACT
Introduction and Objective: Hanging is a form of
violent asphyxial death. It produces painless death for
the victims so that it is a widely accepted method of
suicide. The rate of suicidal hanging cases is increasing
day by day. The Objective of study is to find out
demography of hanging, its distribution according to age
group, sex, most common ligature material used by
victim and observed post-mortem findings and in this
way try to identify the causative factors and developing
the preventive measures that are essential to reduce death
due to hanging.
Material and Methods: A retrospective study of
hanging cases reported to mortuary of Vadilal Sarabhai
General Hospital, Ahmedabad during a period of 2 years,
(from November 2009 to October 2011) is carried out.
Results: Out of total 2244 cases of post-mortem during
2 years, 74 (3.29%) were hanging cases. Maximum cases
34 (45.94%) of death due to hanging seen in age group
21-30 years. Majority of cases 46 (62.16%) were
observed in Males. Majority of victims have used
Dupatta, 40 (54.05%) as a ligature material. Manner of
death is suicide in all cases. Cyanosis, salivary marks
and petechial hemorrhage in brain observed in variable
number of cases.
Conclusion: Suicide by Hanging has become very
common now a days. A well designed and
comprehensive programme is needed to identify the
causative factor and prevention of suicidal hanging.
Appropriate education, reducing unemployment,
improving the quality of self esteem and involvement of
young generation in encouraging activities may reduce
rate of death due to hanging.
Key Words:
Asphyxia, Hanging, Suicide.
INTRODUCTION
Hanging is a mechanical form of asphyxia which is
caused by suspension of body by a ligature which
encircle the neck, the constricting force being the weight
of body.[1] Sometimes the body completely suspends
from above and is called complete hanging. When some
part of body touches the ground, the procedure is called
incomplete or partial hanging.[2] A good number of
people die each year by suicide, making it one of the 10

leading causes of death in the world.[3] Hanging produces
painless death for the victims. A thin rope around the
neck will cause unconsciousness in 15 seconds.[4] So the
people prefer it as a common method of suicide.
MATERIAL AND METHOD
A retrospective study of hanging cases reported to
mortuary of Vadilal Sarabhai General Hospital,
Ahmedabad during a period of 2 years, from November
2009 to October 2011 was carried out.
OBSERVATION
A total of 2244 medico legal autopsies were conducted
during the period from Nov 2009 to Oct 2011, of which
74 (3.29%) were deaths due to Hanging.
(1) Sex & Age wise distribution (n=74)
Table 1: Sex wise distribution
Sex
No. of Cases
Male
46 (62.16%)
Female
28 (37.83%)
Total
74 (100%)
In present study, the majority of the victims were Males
46 (62.16%) while the females were 28 (37.83%) in
number. Male to female ratio found to be 1.64:1.
Table 2: Age wise distribution
Age group(yrs)
No. of Cases
<10
0
11-20
13
21-30
34
31-40
13
41-50
6
51-60
3
61-70
5
>70
0
Total
74

Percentage
0.00%
17.56%
45.94%
17.56%
8.11%
4.05%
6.76%
0.00%
100%

Above table shows that most vulnerable age group was
21 to 30 years with total cases 34 (45.94%) out of 74.
(2) Ligature material used (n=74)
Out of total 74 cases, most common ligature material
used was dupatta in 40 (54.05%) cases followed by
Nylon rope in 18 (24.32%) cases. Electric wire was used
in 5 (6.75%) cases, Cloth in 3 (4.05%) cases, Sari in 3

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(4.05%) cases and Bed sheet in 2 (2.70%) cases. Curtain,
Muffler and Belt each was used in 1 (0.74%) case.
Table 3: Distribution according to ligature material
used
Material used
No. of Cases Percentage
Dupatta
40
54.05%
Sari
3
4.05%
Nylon rope
18
24.32%
Electric wire
5
6.75%
Muffler
1
0.74%
Bed sheet
2
2.70%
Curtain
1
0.74%
Cloth
3
4.05%
Belt
1
0.74%
Total
74
100%
(3) Manner of death according to inquest
All cases of hanging were suicidal according to inquest
(100%).
(4) Type of hanging according to position of knot
13 (17.56%) cases out of 74 were observed to be of
typical hanging while 61 (82.43%) cases were of
Atypical hanging.
(5) Post mortem findings
Table 4: Post mortem findings
Post mortem
No. of Cases Percentage
Finding
Sub conjunctival
19
25.66%
haemorrhage
Cyanosis
70
94.59%
Petechial
20
27.03%
haemorrhage
Face congestion
8
10.81%
Salivary mark
22
29.73%
Total
74
100%
Out of 74 cases, Cyanosis was found in 70 (94.59%)
cases and dribbling marks of saliva were seen in 22
(29.72%) cases. Observed petechial hemorrhages in
brain were in 20 (27.02%) cases while sub conjunctival
hemorrhages were noticed in 19 (25.67%) cases. Face
was congested in 8 (10.81%) cases, Injury to sub
cutaneous tissue underneath the ligature mark was found
in 3 (4.05%) cases and Injury to the neck muscles in 4
(5.40%).
DISCUSSION
(1) Relation of Age factor:
Observed maximum percentage of violent asphyxial
death in age group 21-30 yrs was 34 cases (45.94%). As
it is the most active period in ones life and there are great

fluctuations of emotions in this age group. Besides the
age group from 21-30 yrs, young people get frustration
due to various reasons such as unemployment, family
acceptance, poverty and love failure etc so most of the
cases were below 40 years of age. All these causes form
the motivational factors to terminate their lives.
(2) Male Female ratio in Hanging:
Males 46 (62.16%) outnumbered the females 28
(37.83%). This may be because of activeness of male in
the society and female being more accommodative to
changing mentally and traumatic circumstances. Suicidal
hanging were more common among males, reason due to
increasing depression among young people, leading to
suicidal attempts.[5,6]
(3) Manner of Death:
All cases 74 (100%) found to be Suicidal in nature. They
were all ante-mortem in nature and showed typical
finding.
(4) Ligature material used:
Table 3 depicts that majority of victims used dupatta 40
(54.05%) followed by nylon rope in 18 (24.32%) cases.
Electric wire was used in 5 (6.75%) cases, Cloth in 3
(4.05%) cases, Sari in 3 (4.05%) cases and Bed sheet in
2 (2.70%) cases. Curtain, Muffler and Belt each was
used in 1 (0.74%) case.
(5) Type of Hanging according to position of knot:
In present study 61 (82.43%) cases showed right or left
sided knot that indicate atypical hanging while only 13
cases (17.56%) showed knot was located on nape of
neck that indicates typical hanging.
(6) Post mortem findings:
In present study Cyanosis of fingertips and nail beds of
both hands observed in 70 (94.59%) cases which was the
commonest finding followed by dribbling marks of
saliva in 22 (29.72%) cases. Petechial hemorrhages in
brain were observed in 20 (27.02%) cases while Sub
conjunctival hemorrhages in 19 (25.67%) cases. These
findings being the most important signs of asphyxia and
are mentioned in every literature available. In hanging
out of 74 cases, 53 (71.62%) were associated with
injuries like abrasions and contusions. Sub cutaneous
tissues found typically pale white and glistening in 71
(95.95%) cases. Sub cutaneous tissue was noted reddish
in one case and ecchymosed in one case. Out of 74
cases, neck muscle injuries were found in 4 (5.41%)
cases.

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CONCLUSION
In our study following are the conclusions we have come
across.
A: The maximum i.e. 34 (45.94%) cases of death due to
hanging occurred in age group between 21-30 yrs.
B: All of hanging cases were suicidal in nature i.e. 74
(100%).
C: Majority of victims i.e. 40 (54.05%) used dupatta
followed by nylon rope i.e. 18 (24.32%) and electric
wire i.e. 5 (6.75%) for asphyxial death.
D: Cyanosis of fingertips and nail beds i.e. 70 (94.59%)
and dribbling salivary marks i.e. 22 (29.72%) were the
commonest findings in cases of asphyxial death due to
hanging.
E: The number of suicidal hanging cases is increasing
day by day. A well designed and comprehensive
programme is needed to identify the causative factor and
prevention of suicidal hanging. Appropriate education,
reducing unemployment, improving the quality of self
esteem and involvement of young generation in
encouraging activities may reduce rate of death due to
hanging.

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