Strangulation (z7396)

STRANGULATION (from Latin strangulo--I strangle), asphyxiation caused by compression of the neck with a ligature or hand. Three forms of S are distinguished: 1) hanging, 2) ligature strangulation, and 3) manual strangulation. In hanging (see), the ligature is tightened on the neck by the weight of the body; in ligature strangulation, the ligature is tightened by another person's or one's own hand, sometimes with the use of various devices. Pressure from the ligature on the neck leaves a mark in the form of a groove or furrow, the so-called s t r a n-g u l a t i o n a l groove. A brown strangulation groove and a pale one are distinguished. The first occurs when the ligature is made of a hard material and, when pressing or sliding along the neck, abrades the skin. The serous fluid that exudes along the line of abrasion then dries, causing the groove to take on a brown color and parchment-like density. Along the course of the groove and at its edges, dilated vessels and small hemorrhages can sometimes be noticed. For this, it is recommended to dissect the groove and examine it in transmitted light. If the ligature had several turns around the neck, then correspondingly the groove may be double, triple, etc. Between individual turns of the ligature, skin is often caught, forming ridges, at the apexes o-f which point hemorrhages are noted. The presence of hemorrhages along the course of the strangulation groove and on the pinched skin ridges with certainty indicates its antemortem origin. A pale groove is obtained either from a ligature of soft material (scarf, towel, etc.), when the ligature only presses on the skin without abrading it, or because the ligature was on the neck for a short time. With short-term pressure of the ligature on the neck, the s t r a n-g u l a t i o n a l groove may be completely absent. The direction of the groove is important diagnostically (see Hanging). Postmortem phenomena in death from strangulation are the same as in other types of asphyxia. It should only be noted the sharp venous congestion of the facial skin, often with extensive ecchymoses, especially in ligature strangulation (manual strangulation see Strangulation).