Delayed death in hanging- a case report

Hanging is form of asphyxia which is caused by suspension of the body by a ligature which encircles the neck, the constricting force being the weight of the body. The term ‘Near hanging’ refers to victims who survive a hanging injury long enough to reach hospital. Hanging is preferred method of suicide as death is painless and almost instantaneous. However, with immediate rescue, aggressive resuscitation and intensive care, many patients survive for longer periods. Prolonged stay leads to disappearance of external evidence of ligature mark and other injuries which makes the task challenging for forensic experts. But meticulous clinical documentation can be of great help. We present case of 25 years old married female who survived for 33 days after attempted suicide by hanging. On admission, she was received intubated with stable vitals. She was on ventilatory support and remained unconscious throughout the period of stay. Cause of death was opined as death due to Hypoxic Encephalopathy as result of complication of Ante-mortem Hanging which was consistent with MRI and Histopathology findings.