Title: A Study of Morphology and Histopathology of Ligature Marks in Asphyxial Deaths by Compression of Neck in Jodhpur Region, Rajasthan

Authors: Dr Navneet Sharma, Dr Amit Shrivastava, Dr P.C. Vyas

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i6.170

Abstract

Introduction: The ligature mark is vital piece of evidence in asphyxia deaths. There has been extensive study about external appearance of asphyxia deaths due to hanging and ligature strangulation but histopathological study of the neck structures in these cases are very few. In this study an attempt has been made to establish the most reliable morphological and histopathological features for differentiating the pattern of ligature mark in cases of asphyxial deaths.

Materials and Methods: Hospital based observational study was carried out at a tertiary care teaching hospital of western Rajasthan over a period of one year. Total 104 cases of hanging and strangulation were taken for study. Details about morphological findings of ligature mark were noted and tissue section including samples of skin, subcutaneous tissue, muscles, thyrohyoid complex and cervical lymph nodes from neck beneath the ligature mark were dissected out and sent in 10% formalin for histopathological examination.

Results: Common morphological findings of ligature mark in hanging were single (91%), atypical (89%), discontinuity of ligature mark (98%), incomplete encirclement (98%),  oblique mark (100%), Parchmentisation (56%), Reddish-browncolour (23%), pale (21%) while in ligature strangulation these were single (50%), multiple (50%), discontinuity of ligature mark (25%), complete encirclement (75%),  transverse (75%), Parchmentisation (50%), Reddish-browncolour (50%), extravasation of blood (100%). Common histopathological findings of ligature mark in hanging were abraded epidermis (38%), dermal congestion (48%), muscle hemorrhage (37%), muscle necrosis (7%), muscle autolysis (9%),  perifollicular congestion (23%), perifollicular hemorrhage (7%), congestion of lymph node (21%)while in ligature strangulation these were dermal hemorrhage (75%), dermal congestion (25%), muscle hemorrhage (75%) muscle necrosis (25%), perifollicular hemorrhage (75%) and congestion of lymph node (100%).

Conclusion: The present study concluded that a detailed evaluation of the gross and histopathological findings of the ligature mark, if undertaken would be more conclusive in establishing the cause and manner of death to aid in the administration of justice.

Keywords: Asphyxial deaths, hanging, strangulation, ligature mark, morphology, histopathology.

References

  1. Camps FE, Robinson AE, Lucas BGB. Gradwohi's Legal Medicine. 3rd Bristol: Johnwright and Sons. 1976. Hypoxia and Asphyxia;p-331-34.
  2. Simonsen J. Patho-Anatomic Findings in neck structures in Asphyxiation due to hanging : (A survey of 80 cases). Forensic Science International. 1988;38:83-91.
  3. Mallikarjun BS, Dayananda R et al. Study of ligature mark in hanging cases in banglore east region. J.IA.F.M. 2016;18-20.
  4. Deidiker, Russell D. Accidental ligature strangulation due to a roller type massage device. The American Journal of Forensic Medicine & Pathology. 1999;20(4):356-359.
  5. Momonchand A, Meeradevi T H, Fimate L. Violent asphyxia death in Imphal. Journal of Forensic Medicine & Toxicology. 1998;15(1):­60-64.
  6. Khaja S. Fractured Hyoid Bone with Separated Fragment and Type of Fracture. Journal of Indian Academy of Forensic Medicine. 2009.31(1):61-63.
  7. Joshi R, Chanana A, Hakumat R. Incidence and medico legal importance of autopsy study od fracture of neck structure in hanging and strangulation. Medico legal Update. 2007.;7(4):105-09.
  8. Shrama BR, Harish D, Singh VP. Ligature mark on neck how informative- (A study paper). Journal of Indian Academy of Forensic Medicine. 2005; 27(1):10.
  9. Naik SK. Obliquity v/s Discontinuity of ligature Mark in diagnosis of hanging - (A comparative study). Anil Agarwal's Internet Journal of Forensic Medicine and Toxicology. 2006;7:1.
  10. Jani CB, Gupta BD. An Autopsy Study and Parameter Influencing injury to osteocartilaginous structures of neck in hanging. International Journal of Medical Toxicology and Legal Medicine. 2002;5(1):4-7.
  11. Knight B. Pressure on the neck. In Simpson's K. Forensic Medicine. 9th ELBS London. 1985:87-105.
  12. Parikh CK. Textbook of Medical Jurisprudence, Forensic Medicine and Toxicology.6th New Delhi: CBS Publishers. 2000. Violent asphyxial deaths. pp-342-48.
  13. Reddy KSN. The essentials of Forensic Medicine and Toxicology. 23rd The health sciences publishers. 2014. pp-338-364.
  14. Pillay VV. A Text Book of Forensic Medicine & Toxicology. 15th Paras Medical Publisher. 2010. Pp-274-295.
  15. Nandy A. Principal's of Forensic Medicine Including Toxicology. 3rd New Central Book Agency Pvt. Ltd. 2010. Pp-320-351.
  16. Modi P. Jaising. Textbook of medical jurisprudence and toxicology. 24th Lexis Nevis. 2015. pp-445-467.
  17. Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, Ferguson MWJ. Gray's Anatomy. 38th Churchill Livingstone. 2000. Pp-1094.
  18. Wenyou N, Junzhu H, Xinmun A new staining method for constriction maks in skin. Forensic Science International. 1991;50:147-152.

Corresponding Author

Dr Amit Shrivastava

Email: This email address is being protected from spambots. You need JavaScript enabled to view it.