Neck Findings in Hanging: A Cross-Sectional Comparative Study of Conventional Autopsy and Postmortem CT-Based Virtual Autopsy

绞刑颈部病变的发现:传统尸检与基于死后CT的虚拟尸检的横断面比较研究

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Abstract

Introduction Suicide is a significant public health concern, causing numerous deaths each year, with hanging accounting for the majority of these fatalities. In our country, such deaths require a medicolegal autopsy, even though most relatives of the deceased are often reluctant to consent. Therefore, this study was conducted to evaluate the efficacy of virtual autopsy (VA) using postmortem computed tomography (PMCT) in detecting neck findings in hanging, in comparison to conventional autopsy (CA). Materials and methods This study included 19 cases of hanging brought to a tertiary care center for medicolegal autopsy. All cases underwent VA using PMCT, followed by CA. Neck findings obtained from both autopsy modalities were subsequently compared. Results In this cross-sectional study, 19 cases of hanging were included, comprising 10 females and nine males. There was strong agreement between VA and CA in identifying the ligature material. Examination of the ligature mark showed that VA could detect its presence with 89.5% accuracy and accurately determine the knot position in 84.2% of cases. Fracture of the hyoid bone was observed in one case and was detected by both VA and CA. Conclusions VA using PMCT is effective in determining the neck findings in hanging, especially those of the skin and bony structures. Thus, it can be used as a supplement to the CA in hanging. This will help to reduce the total duration of the autopsy while respecting the sentiments of the next of kin by handing over the body of their loved one intact and without deformity.

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