Evaluation of hanging deaths in childhood: An autopsy study

Hanging is defined as a form of asphyxia caused by the suspension of the body with a ligature around the neck, where the constriction is generated by the body's own weight. The aim of this study is to examine autopsy findings in hanging cases among children, a rare cause of death in this age group, using data collected from a forensic autopsy center.

This retrospective study was conducted by reviewing electronic autopsy reports of pediatric cases referred to the Morgue Department between January 1, 2012, and December 31, 2021, for the determination of the cause of death. Demographic data physical characteristics, scene-related findings and autopsy findings were analyzed.

A total of 162 pediatric cases Of these, 113 (69.8 %) were male and 49 (30.2 %) were female. The age range of the cases was between 5 and 17 years, with a mean age of 15.66 ± 2.42 years. The Body Mass Index (BMI) ranged between 12.85 % and 52.94 %, with a mean of 22.14 ± 5.48 %. No statistically significant correlation was found between age or BMI and the presence of hyoid bone fracture, thyroid cartilage fracture, sternocleidomastoid (SCM) muscle injury, or infrahyoid muscle injury. When findings were evaluated according to the knot location (typical vs. atypical), no significant relationship was found between the knot position and hyoid bone fracture, thyroid cartilage fracture, infrahyoid muscle or SCM muscle injury.

Compared to adult series in literature, the lower frequency of fractures, particularly of the thyroid cartilage, may be attributed to the fact that in pediatric individuals, these structures are less calcified and thus less prone to fracture.

This study represents one of the largest autopsy-based analyses focusing solely on pediatric hanging cases. Preventive strategies should include a careful reassessment of environmental safety to mitigate accidental deaths.