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      Post-obstructive Pulmonary Oedema in Delayed Death by Hanging: A Case Report

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          Abstract

          Hanging is a common method to attempt suicide, which is highly lethal and results in immediate death. Near-hanging refers to those who survive a hanging injury and are able to reach a hospital. Only a few survive such episodes if they are promptly rescued, but they usually die later, which is called delayed death by hanging. Post-obstructive pulmonary oedema is a fatal complication that occurs after the removal of severe upper respiratory tract obstruction. Post-obstructive pulmonary oedema developing in delayed hanging death is not widely reported in the literature. Herein, we describe a case of post-obstructive pulmonary oedema in a 16-year-old girl with a history of attempted suicide by hanging.

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          Delayed Pulmonary Oedema Following Attempted Suicidal Hanging–A Case Report

          Mahendra Kumar Jindal, Rajani Mandhyan, Usha Shukla … (2009)
          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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            Duret haemorrhage: An unusual finding in compression of neck structures

            Alok Atreya, Tanuj Kanchan (2018)
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              Intracerebral and subarachnoid hemorrhage after suicidal "near-hanging".

              Nathalie Schwab, Lorena Díaz, Ignasi Galtés (2022)
              Hanging is one of the most common methods of attempting suicide with a fast occurring death and a high lethality rate. Depending on how fast the hanged individuals are found, they may be rescued, which is referred to as "near-hanging." Whilst hypoxic and ischemic brain damage are common findings in hanging, intracranial hemorrhages seem to be a rare occurrence. To the authors' knowledge, this is the first autopsy case report of an intracerebral and subarachnoid hemorrhage in a delayed death after incomplete hanging. We hypothesize that the combination of two mechanisms is involved in the development of such hemorrhages. First, the persistent venous hypertension during incomplete hanging causing endothelial damage resulting in vascular leakage. Second, the reperfusion of the brain due to recovery of venous blood return after the release form the rope. Whereas intracranial hemorrhage is not a common finding in daily autopsy cases of fatal hanging, it might be a severe complication in rescued cases.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 20 March 2023
                Publication date (Electronic, collection): March 2023
                Volume: 15
                Issue: 3
                Electronic Location Identifier: e36420
                Affiliations
                [1 ] Forensic Medicine, Darbhanga Medical College, Darbhanga, IND
                [2 ] Obstetrics and Gynaecology, All India Institute of Medical Sciences, Patna, IND
                Author notes
                Article
                DOI: 10.7759/cureus.36420
                PMC ID: 10115357
                SO-VID: 54ceec99-e149-4f60-8a81-8f8543e9aafa
                Copyright © Copyright © 2023, Kumar et al.
                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 author and source are credited.

                History
                Date accepted : 20 March 2023
                Categories
                Subject: Forensic Medicine

                Keywords: delayed death by hanging,suicide death,attempted suicide,post obstructive pulmonary edema,near hanging,delayed hanging death
                Data availability:
                Keywords: delayed death by hanging, suicide death, attempted suicide, post obstructive pulmonary edema, near hanging, delayed hanging death

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