Cervical Soft Tissue Emphysema in Hanging—A Prospective Autopsy Study

Authors

  • Slobodan Nikolić M.D., Ph.D.,

    1. Institute of Forensic Medicine, School of Medicine, University of Belgrade, 31a Deligradska str., 11000 Belgrade, Serbia.
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  • Vladimir Živković M.D., Ph.D.,

    1. Institute of Forensic Medicine, School of Medicine, University of Belgrade, 31a Deligradska str., 11000 Belgrade, Serbia.
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  • Dragan Babić M.D., Ph.D.,

    1. Institute of Medical Statistics and Informatics, School of Medicine, University of Belgrade, 15 Dr Subotića str., 11000 Belgrade, Serbia.
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  • Fehim Juković M.D.

    1. Department of Forensic Medicine, County Hospital of the City of Novi Pazar, 36300 Novi Pazar, Serbia.
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  • This study was supported by Ministry of Science of Republic of Serbia, Grant No. 45005.

Additional information and reprint requests:
Slobodan Nikolić, M.D., Ph.D.
Institute of Forensic Medicine
31a Deligradska str.
11000 Belgrade
Serbia
E-mails: bobanvladislav@yahoo.com;slobodan.nikolic@mfub.bg.ac.rs

Abstract

Abstract:  The underlying mechanism of cervical soft tissue emphysema (CSTE) in hanging remains unclear. The aim of this study was to determine the frequency of CSTE in cases of hanging. The sample included 83 deceased persons, average age 55.3 ± 17.9 years. CSTE was established in 44 cases. CSTE is presented as frothy air, soap bubble-like formations in superficial and/or deep connective tissue between the neck muscles up to the ligature mark, visible during gross neck examination, using special neck autopsy technique—preparation of the neck organs in layers. The interpretation of positive CSTE must be taken with caution: it could be an antemortem phenomenon possibly because of either Macklin Effect or direct or indirect trauma to the cervical airways, as well as an ante- or postmortem artifact.

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