Suspended in Time: Post-Mortem CT Features of Hanging – A Case Series

Abstract

Background

Hanging remains a common method of suicide. While diagnosis is primarily scene-based, PMCT can provide valuable documentation of internal injury and exclude competing causes of death.

Hanging remains a common method of suicide. While diagnosis is primarily scene-based, PMCT can provide valuable documentation of internal injury and exclude competing causes of death.

Methods

A series of hanging deaths undergoing PMCT were reviewed. Features of cervical skeletal injury, soft tissue changes, and airway/vascular appearances were recorded and compared with autopsy.

A series of hanging deaths undergoing PMCT were reviewed. Features of cervical skeletal injury, soft tissue changes, and airway/vascular appearances were recorded and compared with autopsy.

Results

Ligature groove was often visible on CT as subcutaneous indentation.

Cervical spine injuries were rare, subtle fractures of the hyoid/thyroid cartilage were variably detected. Airway and vascular structures showed occasional haemorrhage but were frequently unremarkable. PMCT was most useful in excluding major trauma, demonstrating ligature position, and providing 3D reconstructions of the neck region.

Ligature groove was often visible on CT as subcutaneous indentation.

Cervical spine injuries were rare, subtle fractures of the hyoid/thyroid cartilage were variably detected. Airway and vascular structures showed occasional haemorrhage but were frequently unremarkable. PMCT was most useful in excluding major trauma, demonstrating ligature position, and providing 3D reconstructions of the neck region.

Conclusions

PMCT in hangings highlights both its strengths and limitations. While specific internal injuries are infrequent, PMCT offers reliable exclusion of alternative trauma and valuable visual correlation with external findings, contributing to case documentation and teaching.

PMCT in hangings highlights both its strengths and limitations. While specific internal injuries are infrequent, PMCT offers reliable exclusion of alternative trauma and valuable visual correlation with external findings, contributing to case documentation and teaching.