Marrone Maricla, Cazzato Gerardo, Caricato Pierluigi, Angeletti Carlo, Ingravallo Giuseppe, Casatta Nadia, Lupo Carmelo, Vinci Francesco, Agazzino Gisella, Stellacci Alessandra, Oliva Antonio
Section of Legal Medicine, Department of Interdisciplinary Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.
Section of Pathology, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari Aldo Moro, 70124 Bari, Italy.
Diagnostics (Basel). 2023 Jan 30;13(3):510. doi: 10.3390/diagnostics13030510.
To evaluate the usefulness of studying vital injuries at the sternal head insertion of the sternocleidomastoid muscle in the medico-legal assessment of death by hanging.
Study material was obtained from eight bodies of people who died from hanging. The control group included as many specimens collected from people who died from traumatic causes other than hanging (precipitation from medium to large heights and traffic accidents). The structures under study were examined histologically with a BX-51 light microscope (Olympus). An analysis of the extravasated erythrocytes was performed by counting the number per mm in the histologic section on 10 HPF (400×), and Student's -test for a comparison of the averages was applied for all parametric values. The authors noted that the key finding, indicative of the subject's viability at the time of discontinuation, was the presence of recent hemorrhagic infiltrate (in the absence of hemosiderin) at the tendon insertion of the sternocleidomastoid muscle and the proximal part of the muscle itself.
All specimens tested were positive for the presence of hemorrhagic infiltrate at the portions tested in a statistically significant manner. In contrast, in the control cases there was no or, where present, no statistically significant ( < 0.05) presence of recent hemorrhagic infiltrate. The limitation of the study is the low number of samples examined. In any case, the results obtained are strongly indicative of the possibility of using this type of forensic pathological investigation in cases where there is a doubt in terms of a differential diagnosis between hanging (suicidal type) and suspension of a corpse in a simulation of hanging.
评估在法医学上吊死亡鉴定中，研究胸锁乳突肌胸骨端插入处的重要损伤的实用性。
研究材料取自八具上吊死亡者的尸体。对照组包括从非上吊的创伤性原因（从中等高度到较大高度坠落以及交通事故）死亡者身上采集的同样数量的标本。使用BX - 51光学显微镜（奥林巴斯）对所研究的结构进行组织学检查。通过在组织切片的10个高倍视野（400×）中每毫米计数红细胞外渗数量来分析红细胞外渗情况，对所有参数值应用学生t检验进行平均值比较。作者指出，表明受试者在中断时仍存活的关键发现是胸锁乳突肌腱插入处及肌肉近端本身存在近期出血性浸润（无含铁血黄素）。
所有测试标本在所测试部位均有出血性浸润呈阳性，具有统计学意义。相比之下，在对照病例中，没有近期出血性浸润，或者即使有也无统计学意义（P < 0.05）。该研究的局限性在于所检查的样本数量较少。无论如何，所获得的结果强烈表明，在对（自杀型）上吊和模拟上吊悬挂尸体之间的鉴别诊断存在疑问的案件中，使用这种法医病理学调查方法的可能性。
