Multiple self-inflicted stab wounds to neck, chest and abdomen as a unique manner of suicide

Suicide by sharp force associated with major self-mutilation and self-cannibalism

Self-stabbing and self-cutting represents an uncommon method of suicide. We present a case of a 30-year-old man who was found dead in the forest. The body was naked and showed multiple cut and stab wounds on different parts of the body (face, neck, chest, abdomen, and extremities). A single-edged kitchen knife was found approximately 20 m from the body. Parts of both ears, the fifth toe of the right foot, and the scrotum were cut off. At the autopsy, two of the severed body parts-the toe and the part of the left ear-were found in the stomach. The cause of death was asphyxiation due to blood aspiration resulting from a cut throat injury. A police investigation uncovered a history of substance abuse and two previous suicidal attempts using a knife. Upon complex analysis of all the evidence, the manner of death was ruled a suicide, which was preceded by actions of major self-mutilation and self-cannibalism, both considered rare behavioral patterns.

The manner of death in a case with two stab wounds caused by two weapons: case report

Background

Stabbing is a relatively uncommon method of suicide. Typical suicide is usually associated with tentative wounds. Self-stabbing using two sharp weapons to produce two stab wounds without tentative marks is an uncommon incidence.

Case presentation

A 42-year-old Austronesian descent male with a history of family troubles was found dead by his friend inside a clothing store; two kitchen knives were present on both sides of the body. There were two stab wounds in the chest and the abdomen without any superficial hesitation cuts. At the crime scene, there were two blood pools.

Conclusion

The number of injuries with the absence of hesitation injuries raised suspicions of an atypical case of suicide that necessitated further forensic investigations. However, the circumstantial evidence and autopsy findings demonstrated that suicide was the cause of death.

Unusual attempted suicide or covered attempted homicide? A neck stabbing case report and review of literature

A medico-legal consult is frequently required in a clinical context in order to assess the eventual compatibility of specific wounds with a self- or hetero-infliction. Accordingly, the case of a 52-year-old man with a single, penetrating stab wound of the neck, reported as self-inflicted, is here presented. The forensic aspects, taken into account in order to determine the self- or hetero-infliction nature of the wound, are further discussed and compared to cases described in the literature.

Self-inflicted neck wounds under influence of lysergic acid diethylamide: A case report and literature review

RATIONALE

Lysergic acid diethylamide (LSD) is a highly potent psychedelic drug derived from ergot alkaloids. The available literature data derived from controlled studies or usage in a medical setting seem reassuring; however the literature contains very rare cases of fatal self-inflicted injuries associated with LSD exposure. The behavioral disorder that created the conditions conducive to death is a maladaptive or irrational response to the psychiatric manifestations induced by the substance.

PATIENT CONCERN

Here, we report the case of a 26-year-old man found dead with large neck wounds in a locked house. No medical history other than recreational use of alcohol and narcotics was reported as well as any history of psychotic disease. The entirety of the other investigations carried out did not demonstrate the presence of a third party at the place of death and a dropper bottle containing LSD was found near the body.

DIAGNOSIS

We report the first case of fatal self-inflicted neck wounds with a cutting instrument in the context of acute exposure to LSD in a patient with no psychiatric history and without suicidal symptoms at the time of the self-aggressive act.

INTERVENTION AND OUTCOMES

In the present work, we used a validated method using liquid chromatography coupled with mass spectrometry for simultaneous quantification of LSD and its metabolites (O-H-LSD and Nor-LSD) in whole blood and urine samples. LSD and O-H-LSD were respectively found at 1460 and 182 pg/mL in blood. In the urine, the concentrations of LSD, nor-LSD, O-H-LSD were, respectively, 3670, 201, and 4890 ng/L.

LESSONS

This observation is particularly relevant in view of the resurgence of interest in the therapeutic use of LSD, notwithstanding the fact that the literature has not demonstrated a link between suicidal risk and acute or chronic exposure to LSD.

Suicidal self-stabbing: A report of 12 cases from Crete, Greece

Sharp-force trauma is a popular cause of homicide and suicide in many countries. Characterisation of the injuries between the two is crucial for a differential diagnosis. The current paper reviews 12 self-inflicted sharp-force trauma deaths from the island of Crete in Greece. Forensic reports between 1999 and 2015 were collated, and we studied the number and location of injuries, the demographic characteristics of the deceased, the sharp object and the medical history of the deceased. One third of the cases where the forensic reports were available (3/10) involved multiple injuries, and one case involved a combination of stabbing and hanging. Most injuries involved a kitchen knife. Ninety-two per cent (11/12) of the victims involved male Greek nationals aged >50 years. The type and location of injuries were not found to be specific to suicide alone. Thus, death-scene investigation remains crucial to the differential diagnosis between suicide and homicide. This is the first report on self-inflicted sharp-force fatalities in Greece.

Complex suicide by self-stabbing with subsequent drowning in the sea

The paper presents a unique case of a complex suicide committed by a young man, mostly probably triggered by a disappointment in love. The uniqueness of the suicide lies in the fact that the victim inflicted several deep stab wounds on himself, in the chest and abdomen, while standing partly submerged in the sea and, having done so, he dropped and disappeared in the water. The postmortem examination showed, apart from deep wounds in the trunk, characteristics of drowning that manifested itself in the form of aqueous emphysema of the lungs. Suicide was clearly determined on the basis of the circumstances preceding death, the location, and arrangement of the trunk wounds and the testimony given by a witness of the incident. The circumstances preceding the suicidal act clearly suggest an underlying undiagnosed mental disorder.

Suicide by Extraordinarily Numerous Blade Wounds

A 42-year-old man with a history of suicidal ideation, was found dead in his garage, with over 54 stab wounds and with multiple cuts. The house was locked and the bay door of the attached garage was closed when his live-in girlfriend arrived home and found him. The scene was bloody and a knife was beside the body. Multiple stab wounds involved the neck and the left pectoral region of the chest, and a single stab wound involved the epigastrium. Incised wounds involved the neck and upper extremities. The head, back, genitalia, and lower extremities had no wounds. The blood smears and spatters in the garage, including a bloody footprint, all were attributable to the decedent. The combined consideration of the history, circumstances, and autopsy findings clearly pointed to self-infliction as the manner of death. Most reported cases of suicide by blade involve fewer than 15 stab wounds. This case report, with a brief review of the literature, underscores the concept that multiplicity of stab wounds does not preclude the diagnosis of suicide.

Multiple severe stab wounds to chest with cuts to the ribs. Suicide or homicide?

This paper presents the case of a 36-year-old man found dead in a forest near his home with multiple stab wounds on the chest and abdomen, while the chest wounds penetrated deep into the left pleural cavity and the lung parenchyma, completely cutting through the bone sections of four ribs along the channels of the wounds. In addition, a kitchen knife dug into the ground was found in the immediate vicinity of the corpse. The deceased was wearing a T-shirt with numerous clearly visible holes in places corresponding to the wounds and quite a large tear at the bottom. The post-mortem revealed 19 distinct wounds of the chest as well as a dozen or so superficial marks of cuts or pricks with a pointed tool on the torso. The findings of the police investigation suggested that shortly before death the man was in a bad mood and he had been telling his friends to prepare for his funeral, which was supposed to point to suicidal tendencies. Could, however, such numerous and heavy bodily injuries have been self-inflicted and would such a wounded person still be able to dig a knife into hard forest bed? If yes, in this case we are most probably dealing with aggressive self-destruction, a type of behavior sometimes observed in people suffering from serious mental disorders.