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An Unusual Suicide Case by Combination of Choking and Hanging

Vapa, Dusan MD; Radosavkic, Radosav MD; Maletin, Miljen MD; Veselinovic, Igor MD, PhD

The American Journal of Forensic Medicine and Pathology: December 2012 - Volume 33 - Issue 4 - p 305–306
doi: 10.1097/PAF.0b013e31822d31c0
Case Reports

A 40-year-old man was found dead in his prison cell, hanging on a twisted bandage tightened around his neck. His permanent metal tracheostomy tube was completely corked with a piece of paper wrapped with transparent cellophane from a cigarette case. After police investigation and complete autopsy, suicide was determined as the manner of death. Although suicides by 1 form of asphyxia are relatively common, combination of several different forms of asphyxia is far less frequent. We present this unusual and very rare case of suicide by combination of 2 forms of asphyxia, that is, choking and hanging, along with autopsy findings and discussion.

From the Institute of Forensic Medicine, Clinical Centre of Vojvodina, Vojvodina, Serbia.

Manuscript received January 26, 2011; accepted June 7, 2011.

The authors report no conflicts of interest.

Reprints: Dusan Vapa, MD, Institute of Forensic Medicine, Clinical Centre of Vojvodina, Hajduk Veljkova 1-7, 21000 Novi Sad, Vojvodina, Serbia. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.