“Bowel wall hemorrhage”: A characteristic sign in hanging death

Bowel wall hemorrhage is recently suggested as a characteristic sign of death by hanging. This prospective cross-sectional study was carried out to determine the frequency of bowel wall hemorrhage in autopsies performed on corpses identified as death-by-hanging in Tehran's autopsy hall. All hanging cases from June 2011 to end of June 2012 were included in this study. Demographic data were collected, physical examination was completed and postmortem changes were recorded in all cases. Autopsies were performed focused to identify bowel wall hemorrhage. Severe putrefied corpses, cases with the history and signs of abdominal trauma, history of coagulopathies and chronic intestinal diseases were excluded from this study.The frequency and standard deviation were calculated. T-test and Chi-square test were used to analyze the data. 138 hanging cases were studied. Bowel wall hemorrhage was confirmed by microscopic examination in 16 cases (11.6%). The mean age was 35.31 ± 11.41 years. The mean of height, weight and BMI were 173.25 ± 6.06 cm, 71.56 ± 7.76 kg, and 28.80 ± 2.01 kg/m2 respectively. Hanging was complete in 9 cases (56.2%).Our findings show that after exclusion of other conditions leading to intra-abdominal congestion, presence of bowel wall hemorrhage, especially in the small bowel, can be an important sign for death by hanging together with other previously described signs.