In this paper, we present an illustrative case of bonding disorder, the results of which are presented below:
This is the corpse of an elderly woman, found dead at home without signs that the door of the house had been forced.
The body was in the bedroom, in a supine, lying position, tied to hands and feet with different garments of dressing and damping.
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After the survey, we proceeded to perform the autopsy at the Cartagena Forensic Anatomical Institute, obtaining the following data.
The external examination of the cadaver showed the existence of the following lesions:
Left eye hematoma
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- Deep mucosal skin tear in the upper right ear with haemorrhagic infiltration marked with the letter A.
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Lesions compatible with the neck: - Hematoma on the front edge of the right side with irregular contour marked with the letter A. - Hematomas on the right lower edge of the jaw marked with the letter B. - Small side
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- Hematoma, approximately three cm in diameter in the left plateau, with vitality characteristics as shown after sectioning the skin at that level and observing the differential diagnosis with the subcutaneous cellular smooth muscle layer,
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Following the opening of the cadavers, the following results were obtained in the internal examination.
In the skull: - In the perineum, when evertiring the cutaneous flaps, several hematomas with vitality characteristics mainly located in the posterior region and right region of the same could be observed.
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- In the brain, left hemisphere consistent with old stroke was observed.
In neck: - In neck, the presence of vital hematomas in the lower edge of the neck, marked with the letter A, were observed, these being more evident in photography 11, in which horizontal skin was examined once more
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Blood and lymphatic system disorders
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Blood in the deep planes of the neck
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- Posterior pharyngeal wall petechiae marked with the letter A
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- Plequias and hematomas in the posterior palate.
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Signs of pulmonary congestion, as well as generalized abdominal visceral congestion in solid organs were found in the thorax and abdomen.
Pathological studies: Two swabs of the oral and vaginal cavity were taken to determine the presence of sperm with negative results.
MEDICAL CONSIDERATIONS
Since its difficulties were still outstanding in 1829, there was a celebrated aphorism related to the difficulties in the differential diagnosis of death or dying; however, there has been a long time since its beginning.
This is of great interest because, in most cases, hanging is of suicidal origin, while the damage due to loop is usually due to chance.
Likewise, sometimes one tries to simulate a suicide hanging, when the origin of death is another [2,7,8,9].
We can establish as macroscopic differences between the hanging furrow and the loop projection the following:
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The hanging furrow has a horizontal dorsal upward orientation [5] or, sometimes descending, which is the given direction constrictor to the victim, lying on the floor or lying on the floor, over the floor.
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Hanging furrows are located above the thyroid cartilage and stretch marks are at or below the cartilage [5].
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Hanging furrow is of variable depth, while the string is uniform around the neck [4].
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The bottom of the groove is almost always perturbed in the drowning, while in the estratum it is exceptional, with a blushing aspect.
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There are no other signs of violence in hanging than those produced by the victims lack of affection and the possibility of suffering due to the oscillation of her body (almost always [1].
All these characteristics are orientative, since cases of loop erosion can be found with a single groove, ascending and incomplete oblique.
Perhaps the situation of the groove (below the thyroid cartilage in the stricture) is the most valuable differential criterion with respect to hanging, although not conclusive [1].
In the case of small neighbors, the error can be found in the groove ungual stigma or rounded stigmas produced by a previous attempt to settle and attack the victims own hand.
Different types of blunt injuries can be found in other body areas, especially excoriations and ecchymosis, which are not rarely located in the occipital and scapular regions.
Attempts to calm the victim may cause nail stigmata and ecchymosis around the mouth and ecchymosis on the inner side of the lips [10].
In accusation and inclination to snare, the face contour is very intense and petechial hemorrhages are very abundant.
In the internal examination of the neck, the findings basically consist of hemorrhagic episodes in soft tissues [15] and osteocartilaginous ruptures [11,12], as a pre-fracture of the pharynx and connective tissue rupture is usually treated.
On the other hand, neither the Argentine line nor ruptures in the vascular intima typical of hanging are found, since the production of this last class of lesions implies a longitudinal traction of the neck that does not occur in the dissection [1].
In the rest of the internal examination, in addition to the general and nonspecific lesions of asphyxia [16], blunt lesions may be evident, especially in the pericrania.
In the case in question, the deceased had some injuries and stigmas that allowed to establish how the facts could be developed.
In order to make it clearer, injuries due to anatomical areas are included, since this classification can be achieved through chronological and intentional development.
A left eye hematoma appears on the face.
This lesion is compatible with that produced by a blunt object such as a fist.
In the pericrania appear a series of hematomas fundamentally located on the right side.
These hematomas could be produced by hitting the skull against a hard object, such as soil.
There is a lesion affecting the right ear.
In the neck are the lesions that caused death.
-Hema in the right lower zone of horizontal direction, without causing skin perforating, so that the lesions produced could be produced. There could be several loops of the right lower jawbone in the left side.
In the posterior part of the chest, a hematoma appeared in the plateau, highly prevalent and vital, which must have been produced by the elbow to use this zone as a support point for and as a marker.
From all the above, the following chronology can be established:
A) The elderly woman suffered a left eyebrow with a lie located in front of the victim.
B) Then sits in a chair and taking a combination of the victim puts it around the neck.
Start pulling the victim's hook and scrub in prone position.
(C) Put on it then, bearing the elbows on the top of the snare plates and screwing up and down the top.
Then he returned and took her to bed.
When death occurred, the victim had to be in the prone position and later was changed position which is explained by observing the distribution of the stool spots described in the external examination Prone position was placed on the right thigh.
Then, the wounded letter was produced in the united zone, then a line was produced at the junction point of both thighs, marked with the letter A. Finally, the corpse was placed in a supine position, with the
