kjlm The Korean Journal of Laboratory Medicine Korean J Leg Med 2383-5702 2383-5710 The Korean Society for Legal Medicine 10.7580/kjlm.2020.44.1.31 kjlm-44-31 Case Report Unusual Suicide Cases of Asphyxiation by Ligature within the Vehicle KimDae Yoil 1 LeeSangHan 2 Scientific Investigation Department, Gyeongbuk Provincial Police Agency, Andong, Korea Department of Forensic Medicine, School of Medicine, Kyungpook National University, Daegu, Korea Correspondence to SangHan Lee Department of Forensic Medicine, School of Medicine, Kyungpook National University, 680 Gukchaebosang-ro, Jung-gu, Daegu 41944, Korea Tel: +82-53-420-4887 Fax: +82-53-422-4712 E-mail: sanghan1@knu.ac.kr 12020 812020 441 3136 30012020 16022020 25022020 Copyright © 2020 The Korean Society for Legal Medicine 2020 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract

One of the most common methods of suicide is hanging, and suicide by ligature strangulation is quite rare. Vehicles have a confined space, making them an unusual place for committing suicide by hanging or ligature strangulation, because they are more typically the location of suicide by carbon monoxide intoxication by briquette or drug intoxication. Here, we present three cases of unusual suicide by ligature strangulation, discuss the mechanism of asphyxia in each case, and review the literature. In case 1, the victim used a backpack to perform reverse hanging by wrapping the shoulder strap of the backpack around his neck and then tossing the backpack behind the backrest of the driver's seat. In case 2, the victim did not use the internal structures of the vehicle, but pulled down on a ligature wrapped around both his knees and neck. In case 3, the victim hanged himself using a package line fixed to the roof handle grab of the back passenger seat.

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(A) The victim was sitting in the driver’s seat with his neck tilted backward. The victim showed severe facial congestion. (B) The backpack was placed behind the backrest of the driver’s seat.

(A) The victim was seated in the driver’s seat and his head had moved forward at the driver’s handle. (B) The ligature crossed and wrapped once around the neck and was connected with ligatures wrapped separately around his legs.

(A) The victim was found sitting on the floor of the back seat with his legs extended. A nylon rope was tied to a handle inside the vehicle, and a knife and bundle of the rope used were found on the back seat. (B) Based on the fact that three suspension points were found on the handle, his two previous attempts had failed.