Forensic Science, Medicine, and Pathology

, Volume 13, Issue 2, pp 245–247 | Cite as

Ligature induced blister formation in hanging—the “pinch” effect

  • Jade Spinelli
  • Neil E. I. Langlois
  • Roger W. ByardEmail author
Images in Forensics

Case reports

Case 1

A 67-year-old man with a history of previous suicide attempts was found hanging by a natural fiber cord (5 mm in diameter) in his garage. This had been doubled and looped around his neck twice with no knot.

At autopsy the most significant findings were limited to the neck where there was a double ligature circumferentially around the neck with underlying parchmented marks rising posteriorly to a suspension point over the occiput. An usual feature was blistering between the ligature marks on the left side of the neck (Fig. 1). Lividity was noted in the lower limbs and feet with no facial or conjunctival petechiae. There were no other injuries noted and coincidental findings included severe stenosing coronary artery atherosclerosis, myocardial fibrosis and an old depressed fracture of the skull. Toxicology revealed no alcohol or common prescription or illicit drugs. Death was due to neck compression from hanging.


Compliance with ethical standards

Ethical approval

This article does not contain any studies with human participants performed by any of the authors. Approval to report the case was given by Forensic Science SA, Adelaide Australia.


This study was not funded.

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Byard RW, Heath KJ, Tsokos M. The symmetry of self mutilation and the chess board pattern. Forensic Sci Med Pathol. 2013;9:106–7.CrossRefGoogle Scholar
  2. 2.
    Tse R, Sims N, Byard RW. Alcohol ingestion and age of death in hanging suicides. J Forensic Sci. 2011;56:922–4.CrossRefGoogle Scholar
  3. 3.
    Austin AE, van den Heuvel C, Byard RW. Suicide in forensic practice—an Australian perspective. Aust J Forensic Sci. 2011;43:65–76.CrossRefGoogle Scholar
  4. 4.
    Prahlow J, Byard RW. An atlas of forensic pathology. New York: Springer; 2012.CrossRefGoogle Scholar
  5. 5.
    Byard RW. Issues in the classification and pathological diagnosis of asphyxia. J Forensic Sci. 2011;43:27–38.Google Scholar
  6. 6.
    Payne-James J, Busuttil A, Smock W. Forensic medicine: clinical and pathological aspects. San Francisco: Greenwich Medical Media; 2003.Google Scholar
  7. 7.
    Jayaprakash S, Sreekumari K. Pattern of injuries to neck structures in hanging-an autopsy study. Am J Forensic Med Pathol. 2012;33:395–9.CrossRefGoogle Scholar
  8. 8.
    Pircher R, Epting T, Schmidt U, Geisenberger D, Pollak S, Kramer L. Skin blister formation together with patterned intradermal hematoma: a special type of tire mark injury in victims run over by a wheel. Forensic Sci Int. 2015;249:42–6.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Jade Spinelli
    • 1
  • Neil E. I. Langlois
    • 1
  • Roger W. Byard
    • 1
    Email author
  1. 1.School of MedicineThe University of AdelaideAdelaideAustralia

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