Phénomènes agoniques de la pendaison : à propos d'un cas

If one of the forensic autopsy aims is to determine the medical cause of death, another key question remains the determination of the manner of death. One of the difficulties for the pathologist confronted with the discovery of a hanging corpse is the distinction between suicidal vital hanging, criminal vital hanging and post-mortem suspension. We report the case of a man found hung at home. External examination showed a hanging ligature mark and signs of asphyxia. Dried blood droplets were observed on hands but no wound was found. As blood was also present in the nostrils, it can be hypothesized that a sudden epistaxis was at the origin of the projection of blood on the cadaver's hands. The autopsy excluded any cranio-cerebral trauma and concluded that the death was due to a hypoxia by hanging suicide, considering the presence of epistaxis as an agonal phenomenon. Other post-mortem artifacts encountered in cases of hanging have been described in the literature, most often associated with hypoxic agonal phenomena. The knowledge of such artifacts is crucial for the forensic pathologist to avoid potential misinterpretation.