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      Delayed Pulmonary Oedema Following Attempted Suicidal Hanging–A Case Report

      case-report

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          Abstract

          Summary

          During suicidal hanging, death takes few minutes to occur. Patient, if rescued, may develop respiratory distress, pulmonary oedema, convulsions, raised intra cranial pressure and unconsciousness immediately after incidence. We report a young male of suicidal hanging, brought to hospital in unconscious state with decerebrating movements. He developed pulmonary oedema after two hours of incidence. He was resuscitated and treated successfully.

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          Pulmonary edema as a complication of acute airway obstruction.

          Daniel Gates, S J M Holmström, C Oswalt (1977)
          Acute fulminating pulmonary edema developed in three patients after acute airway obstruction secondary to tumor, strangulation, and interrupted hanging (one case each). The common etiologic factor was vigorous inspiratory effort against a totally obstructed upper airway. Acute pulmonary edema followed the event in minutes to hours and required ventilatory assistance to maintain oxygenation. All patients eventually responded to fluid restriction, diuretics, and steroids. One case was complicated by aspiration of gastric contents following respiratory failure. To our knowledge, this condition is previously unreported in English literature. We presume that the pathogenesis is related to alveolar and capillary damage, induced by the severe negative pressure generated by attempting to inspire against the closed upper airway.
          Article 0 comments Cited 34 times – based on 0 reviews     Review now
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            Airway and respiratory management following non-lethal hanging.

            Lori E. Crosby, A Kaki, A Lui (1997)
            To review the literature on airway and respiratory management following non-lethal (suicidal) hanging and to describe the anatomy, injury and pathophysiological sequelae and their impact on patient care. A Medline literature search of English-language and English-abstracted papers for 1990-96. Keywords were hanging; strangulation; airway obstruction; pulmonary oedema. Filters were applied to limit the search to relevant citations. (i.e., keywords = pulmonary oedema; filters = postobstructive, neurogenic). Citations were then hand-culled to obtain current and relevant papers about an unusual cohort of patients. A hand search of the bibliographies of relevant papers supplemented the Medline search. A review of our experience at the University of Ottawa adult hospitals over the last decade was also undertaken to determine the relevance of the literature to our clinical experiences. Most victims are young men and survivors are uncommon. Laryngo-tracheal injuries, although reported in 20-50% of postmortem examinations, are infrequent in survivors and have little impact on airway management. Spinal injuries are rare in survivors but should be excluded. Pulmonary complications including pulmonary oedema and bronchopneumonia are implicated in most in-hospital deaths. Pulmonary oedema is likely due to neurogenic factors or negative intrathoracic pressure. Although neurological injury determines outcome following hanging, initial neurological presentation is of limited prognostic value: a poor initial condition does not exclude a good recovery. Airway injuries severe enough to interfere with airway management are uncommon after attempted suicide by hanging. Irrespective of the initial neurological assessment, aggressive and early resuscitation to optimize cerebral oxygenation is recommended.
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              Neurosurgical intensive care.

              Gary M Marsh, Jeffrey Shapiro, Brandon Marshall (1977)
              Article 0 comments Cited 5 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Indian J Anaesth
                Journal ID (publisher-id): IJA
                Title: Indian Journal of Anaesthesia
                Publisher: Medknow Publications (India )
                ISSN (Print): 0019-5049
                ISSN (Electronic): 0976-2817
                Publication date (Print): June 2009
                Volume: 53
                Issue: 3
                Pages: 355-357
                Affiliations
                [1,4,5 ]Professor, Dept. of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Shahdara Delhi 110095
                [2,3 ]Senior Resident, Dept. of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Shahdara Delhi 110095
                Author notes
                Correspondence to: Mahendra Kumar, 47 D, Pocket-A, MIG, GTB Enclave, Shahdara, Delhi. 110093. India, Email: mahendramohit@ 123456yahoo.com
                Article
                Publisher ID: IJA-53-355
                PMC ID: 2900131
                PubMed ID: 20640148
                SO-VID: 22a62d90-b148-4f01-82f7-d3f606cffb43
                Copyright © © Indian Journal of Anaesthesia
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date accepted : 05 May 2009
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: suicidal hanging,pulmonary oedema,hypoxia,convulsions,raised intra cranial pressure
                Data availability:
                ScienceOpen disciplines: Anesthesiology & Pain management
                Keywords: suicidal hanging, pulmonary oedema, hypoxia, convulsions, raised intra cranial pressure

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