[Suicidal strangulation by ligature (author's transl)].

Out of sample of about 15,000 medico-legal autopsies seven cases of suicidal strangulation by ligature were selected. Suicidal strangulation has a frequency of about 0.1% among all suicides and a frequency of about 5% in all fatalities due to strangulation by ligature. In two cases strangulation was achieved by auxiliary mechanisms other than by the own hands. In four other cases the tool was wound around the neck many times with or without a final knot in the frontal position. In another case there was only a single surrounding of rope around the neck with a single knot. The hands of the corpses were rarely found firmly attached to the ends of the tools (two cases), an observation, which does not necessarily indicate the involvement of an additional person. All cases showed extensive congestion of the head and the neck above the level of strangulation with multiple petechial hemorrhages, swelling of the soft tissues, and hemorrhagic infarction of the tongue and the bottom of the mouth. Histologically, these lesions exhibited expressed vital reactions with leukocytosis and incipient emigration of inflammatory cells. These reactions were obviously due to prolonged agony. It is tentatively concluded that suicidal strangulation usually shows a pattern of findings that allows the differentiation of homicide.