Recreational abdominal suspension: a fatal practice. A case report

A 12-year-old girl fatally suspended herself accidentally from a tree branch with a circumferential webbing tape tied round the midtrunk area. This occurred as part of a recreational practice whereby the body, tied in this fashion, could be made to swing in a pendulumlike horizontal plane. She was found dead in this position, hanging transversely one foot above the ground. A complete autopsy showed a tram-line circumferential parchmented bruise of the midtrunk area and bruising of the intercostal muscles and diaphragm with occasional petechiae. The mechanism through which death resulted in this case is believed to have involved a progressive tightening and compression of the primary respiratory muscles, resulting in eventual failure of the respiratory effort.