Suicide by unusual manner of hanging. A case report

We present a case of a 35-year-old man who committed a suicide by unusual manner of hanging. The man positioned his neck between two branches of a cherry tree which were V-shaped. The dead body hung on the tree with the feet 50 cm off the ground. The external examination showed strangulation grooves on both sides of the neck with skin abrasion caused by the compression of the neck between the two tree branches as well as submucosal hemorrhages of both eyelids. Autopsy revealed some of the common signs of asphyxia (hemorrhages under the epicardium and the visceral pleura, acute blood stagnation of the internal organs, liquid blood); hemorrhages in the sternocleidomastoid muscles at their attachment to the sternum; horizontal and parallel ruptures of the intima of the left common carotid artery (Amussat's sign); ruptures of the ligaments and the disc between cervical vertebras 6 and 7 and hemorrhages (Simon's sign). Toxicological blood studies, which were additionally performed, found no evidence of drugs or alcohol.