An Unusual Cut Wrist: A case study and a Review of Literature

Abstract

Background: According to World Health Organization statistics, the annual suicidal death rate is about one million people worldwide (mean mortality rate: 16/100.000). In some countries, suicide is the second leading cause of death in the 10-24-year age group. Wrist cutting is sometimes practiced with the goal of self-harm rather than being a suicidal attempt. However, if the bleeding is copious or allowed to continue unchecked, cardiac arrhythmia which is followed by severe hypovolemia, shock, circulatory collapse or cardiac arrest, and death may ensue. Another aim from self- cutting could be wound fabrication to mimic physical assault. In the current study, the updated knowledge concerning self-inflicted injuries including medicolegal, theoretical, and methodological approaches to assess such incidents, is discussed. Moreover, a rare case of unusual, ambiguous cut – wrist will be presented. It is a case of an Asian, female, domestic worker who was claimed to commit suicide at her sponsor’s house by deliberately cutting her left wrist. In a bloody scene, the deceased was found with a completely severed left wrist leading to a complete left- hand amputation. The right hand with a small bloody sharp knife was found behind the body. After a detailed examination of the death scene and full autopsy, the debate appeared. Both homicidal and suicidal scenarios were possible. However, no evidence was found to confirm the homicidal accusation.Consequently, the case was reported as a possible suicide with no previously reported similar cases in the literature.