Case 1
A 21-year-old healthy man working as a farmer was a victim of an accident while he was working in a field. He was accidentally entangled by a towel that he put around his neck which it was taken in the axle of its tractor. It was wrapped twice around his neck, the anterior left shoulder and the anterior of the thorax. The death occurred immediately.
External examination
Parchment bruising in the basicervical and thoracic indicated a friction of the towel against the skin and a cervical groove, located below, with a wide limit. It is blurry at the posterior and left lateral of the neck (Fig. 1).
Autopsy findings
Cervical and thoracic subcutaneous emphysema, haemorrhagic infiltration of the neck muscles without rupture in the neck skin and a rupture of the oesophagus and trachea at the third tracheal ring (Fig. 2) were present. The carotid arteries, jugular veins, hyoid bone, thyroid cartilage and cervical spine were intact. We noted asphyxia signs as diffuse visceral congestion, petechial in conjunctivae and a pulmonary and cerebral oedema.
Histopathological examination
Samples of soft tissues (brain, lungs, heart, liver, kidneys, spleen and pancreas) were taken, and a microscopic examination was performed on the samples after being fixed in formalin and stained in the standard coloration “haematoxylin-eosin”. Pulmonary and cerebral oedema were present too but with no other specific lesions.
Toxicological examination
Body fluids (cardiac and peripheral blood, urine) and gastric content were sampled for toxicological investigations. Toxicological analyses were performed and were negative.
The death was attributed to the ligature strangulation due to the pressure of the neck by the bath towel being entangled in the tractor.
Case 2
A 30-year-old woman farm worker died 1 h after her arrival to the emergency department of a regional hospital. She was taken by her colleagues after an accidental strangulation by her scarf which it was caught in the drive of a plow attached to a tractor.
External examination
Apart from a tracheotomy, a basicervical groove, complete and posterior and horizontal to the neck, was present (Fig. 3).
Autopsy findings
Haemorrhagic infiltration of the neck muscles without rupture of the skin was present with a partial rupture of the trachea (Fig. 4). The carotid arteries, jugular veins, hyoid bone, thyroid and cricoid cartilage and the cervical spine showed no lesions. In addition, asphyxia signs were found as a diffuse visceral congestion and a pulmonary and cerebral oedema.
Histopathological examination
Samples of soft tissues (brain, lungs, heart, liver, kidneys, spleen and pancreas) were taken, and a microscopic examination was performed on the samples after being fixed in formalin and stained in the standard coloration “haematoxylin-eosin”. Pulmonary and cerebral oedema were present with no other specific lesions.
Toxicological examination
Body fluids (cardiac and peripheral blood, urine) and gastric content were sampled for toxicological investigations. Toxicological analyses were performed and were negative.
The death was attributed to the ligature strangulation due to the pressure of the neck by the scarf being entangled in the tractor.
Case 3
A 32-year-old farmer was a victim of an accident at his work. He was accidentally strangled by a towel which he put around his neck. The towel was taken by a drill pipe of a well. He died on the spot.
External examination
Cervical groove much marked in the posterior neck was present with no other injuries.
Autopsy findings
Bleeding in the muscles of the neck and a tracheal rupture were present at the autopsy. Although petechial haemorrhages were found in the bilateral palpebral conjunctivae, epicardium and scalp, there were no gross abnormalities, other than congestion, were found in other organs.
Histopathological examination
Samples of soft tissues (brain, lungs, heart, liver, kidneys, spleen and pancreas) were taken, and a microscopic examination was performed on the samples after being fixed in formalin and stained in the standard coloration “haematoxylin-eosin”. Pulmonary and cerebral oedema were present with no other specific lesions.
Toxicological examination
Body fluids (cardiac and peripheral blood, urine) and gastric content were sampled for toxicological investigations. The Toxicological analyses were performed and were negative.
The death was attributed to the ligature strangulation due to the pressure of the neck by the towel being entangled in the machine.
Case 4
A 41-year-old farmer was a victim of an accident at his workplace. He was accidentally strangled when his scarf was entangled in a combine harvester while he was in a go-to harvest field. He died on the spot. The sudden and brutal pressure on the neck made severe lesions.
External examination
A soft link (scarf) was presently wrapped around the neck doing two laps without any node. After the removal of the link, we noted the presence of a cervical bottom groove, posterior and left lateral (Fig. 5). This groove was ecchymotic parchment with fuzzy boundaries.
Autopsy findings
Cervical and thoracic subcutaneous emphysema and a disjunction fracture C5–C6 (Fig. 6) with a contusion of the spinal cord (Fig. 7) were present without a rupture of the cervical skin. The carotid arteries, jugular veins, hyoid bone, thyroid and cricoid cartilage and cervical spine showed no lesions. Asphyxia signs as facial and ungueal cyanosis, congestion of the viscera and petechial haemorrhages of the conjunctivae were also present.
Histopathological examination
Samples of soft tissues (brain, lungs, heart, liver, kidneys, spleen and pancreas) were taken, and a microscopic examination was performed on the samples after being fixed in formalin and stained in the standard coloration “haematoxylin-eosin”. Pulmonary and cerebral oedema were present with no other specific lesions.
Toxicological examination
Body fluids (cardiac and peripheral blood, urine) and gastric content were sampled for toxicological investigations. The Toxicological analyses were performed and were negative.
The death was attributed to the ligature strangulation due to the pressure of the neck by the scarf being entangled in the machine.