Accidental Asphyxiophilia Or Suicidal Hanging? - A Case Report

Abstract

Background:

Suicide is the act of taking one’s own life. It is often related to severe distress, the aetiology of which is mostly attributed to psychosocial stressors. Autoerotic asphyxia is a paraphilia and category of sexual masochism characterised by self-strangulation up to the point of loss of consciousness to elicit or enhance sexual arousal. It is an accidental lethal sexual practice in which hypoxia is used to enhance orgasm by strangulation, hanging or suffocation/ exclusion of oxygen with plastic bag. It is often accompanied with other paraphilias such as transvestism and bondage, a great range of paraphilias, sexual aids or pain stimulating agents, pornographic magazines, intimate feminine garments, ropes, bondage, locks, chains, condoms, rubber items and chemical anaesthetics. This case report aims to provide an insight into such cases which are brought for autopsy. Establishing the cause and manner is a challenging task. It will provide important insight into the management of similar cases.
Case Presentation:

We report a case in which conflicting statements and postmortem examination helped to uncover the actual manner of death in a young male found with ligature tied around his neck. Crime scene examination led to the reconstruction of the circumstances of death.
Conclusion:

A case having both the characteristics of suicidal hanging and autoerotic death may lead to confusion in the mind of the forensic pathologist. It is especially important to distinguish from suicidal attempt, as it will be important in diagnosis of future care or management in living persons. In the present case, because of absence of certain characteristic findings as well as the history, the death was designated as accidental. The possibility of suicide must always be entertained even in cases which have typical appearance.