Case ReportsAn Unusual Suicide Case by Combination of Choking and HangingVapa, Dusan MD; Radosavkic, Radosav MD; Maletin, Miljen MD; Veselinovic, Igor MD, PhDAuthor Information 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: [email protected]. The American Journal of Forensic Medicine and Pathology: December 2012 - Volume 33 - Issue 4 - p 305-306 doi: 10.1097/PAF.0b013e31822d31c0 Buy Metrics Abstract 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. © 2012 Lippincott Williams & Wilkins, Inc.