Suspension-associated dislocation of the jaw in hanging

International Journal of Legal Medicine - Tập 137 - Trang 1489-1495 - 2023
Joanna Glengarry1, Megane Beaugeois2, Lyndal Bugeja2, Richard Huggins3, Chris O’Donnell1
1Forensic Services and Department of Forensic Medicine, Victorian Institute of Forensic Medicine and Monash University, Southbank, Australia
2Department of Forensic Medicine, Monash University, Southbank, Australia
3Oral and Maxillofacial Surgery Department, Heidelberg, Australia

Tóm tắt

Hanging is a common type of death, and the role of the medical investigation of such deaths by a forensic pathologist not only requires the determination of the cause of death but providing information to assist in the determination of the manner of death. The forensic pathologist should be well versed in the spectrum of injuries known to be associated with neck compression, to document injuries known to be associated with hanging, but also to identify those that are inconsistent with self-inflicted hanging or that may suggest the involvement of a third party in the death. Comprehensive identification and correct interpretation of external and internal injury are crucial for the appropriate degree of police and coroner/medical examiner investigation. We present two cases of deaths believed to be caused by self-inflicted hanging that were observed to have unexpected unilateral dislocation of the temporomandibular joint identified on routine post-mortem computed tomography, without any evidence of involvement of a third party. This injury was unexplained and had not been previously observed at our Forensic Institute nor was it identified after a review of the published biomedical research literature. Issues regarding the cause of this abnormality, possible mechanisms, and the medicolegal significance of this finding will be discussed.

Tài liệu tham khảo

Freckelton IR, Ranson DL (2006) Death investigation and the coroner’s inquest. Oxford University Press, Australia Australian Bureau of Statistics (2021) Causes of death, Australia. ABS. https://www.abs.gov.au/statistics/health/causes-death/causes-death-australia/2021. Accessed 22 December 2022 Ranson DL, Bugeja L (2017) Medicolegal death investigation: coroner and forensic pathology functions and processes in Victoria Australia. Acad Forensic Pathol 7(4):567–581. https://doi.org/10.23907/2017.048 Lynch MJ, Woodford NW (2014) The role of post-mortem imaging in preliminary examinations under the Coroners Act 2008 (Vic): a forensic pathologist’s perspective. J Law Med 21(4):774–779 (PMID: 25087359) Vanezis P (1989) Pathology of neck injury. Butterworth-Heinemann, London McCabe M, Fyzul NN, Mulligan L, Curtis M, Cassidy M (2020) Review of the pattern of traumatic limb lesions sustained in cases of hanging. J Forensic Leg Med 69:101890. https://doi.org/10.1016/j.jflm.2019.101890 Shkrum ML, Ramsay DA (2007) Postmortem changes: the “Great Pretenders.” Forensic science and medicine: forensic pathology of trauma: common problems for the pathologist. Humana Press Inc., Totowa, NJ, pp 23–64 Prinsloo I, Gordon I (1951) Post-mortem dissection artifacts of the neck; their differentiation from ante-mortem bruises. S Afr Med 25(21):358–61 Pollanen MS (2016) Pitfalls and artifacts in the neck at autopsy. Acad Forensic Pathol 6(1):45–62. https://doi.org/10.23907/2016.005 Haglund WD (1993) Disappearance of soft tissue and the disarticulation of human remains from aqueous environments. J Forensic Sci 4:806–815 Morgan B (2020) Normal anatomy. In: Madea B (ed) Asphyxiation, suffocation, and neck pressure deaths. CRC Press, Boca Raton, FL, pp 88–97 Geisenberger D, Pollak S, Thierauf-Emberger A (2019) Homicidal strangulation and subsequent hanging of the victim to simulate suicide: delayed elucidation based on reassessment of the autopsy findings. Forensic Sci Int 298:419–423. https://doi.org/10.1016/j.forsciint.2019.02.037 O’Donnell C, Woodford N (2008) Post-mortem radiology–a new sub-speciality? Clin Radiol 63(11):1189–1194. https://doi.org/10.1016/j.crad.2008.05.008 Chandy PE, Murray N, Khasanova E, Nasir MU, Nicolaou S, Macri F (2020) Postmortem CT in trauma: an overview. Can Assoc Radiol J 71(3):403–414. https://doi.org/10.1177/0846537120909503