Silent while living, speaks when dead- A case report of manual strangulation

M. Z. G. Saiyed, Chetan B Jani
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Abstract

Victim of throttling in majority of the cases die instantaneously as the perpetrator continues to apply pressure till death ensues. In certain cases, victim may survive for some time if pressure is withdrawn due to any reason. In such cases, after the incident, he/she may not be conscious or able to speak for giving history; but the injuries produced by application of pressure by palms and fingers, if looked for them carefully, may speak by themselves about the incident. Presenting here, a case of 52 years old female, where the “made-up” history by the relatives misdirected the thinking process of the clinicians as the patient could not speak at all at the time of admission to the hospital until death. Autopsy conducted on 5 day of hospitalization revealed typical signs of the homicidal act the victim was subjected to, which could have been identified in the “fresh” stage at the time of admission and could have helped in some more detailed medico legal investigations if it could have been referred to Forensic Medicine experts of the institute. This case report stresses on the need of multi-disciplinary approach at the time of treatment of any patient with suspicious history, to have some different angle of view with regards to medico legal concerns and hence, it is discussed here.
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生前无声,死后有声--一例人工扼颈病例报告
在大多数情况下,掐脖子的受害者会当场死亡,因为施暴者会继续施压,直到受害者死亡。在某些情况下,如果由于某种原因撤去压力,受害者可能会存活一段时间。在这种情况下,受害人在事发后可能意识不清,也无法开口陈述病史;但如果仔细观察手掌和手指施压造成的伤痕,它们本身就能说明事发经过。这里要介绍的是一例 52 岁的女性病例,患者亲属 "编造 "的病史误导了临床医生的思维过程,因为患者从入院到死亡根本无法说话。入院 5 天后进行的尸检显示,受害人有典型的杀人行为迹象,这些迹象本可以在入院时的 "新鲜 "阶段发现,如果能将其移交给研究所的法医专家,本可以帮助进行更详细的医学法律调查。本病例报告强调,在治疗任何有可疑病史的病人时,都需要采用多学科方法,以便从不同角度看待医学法律问题,因此在此进行讨论。
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