Self-strangulation: an uncommon but not unprecedented suicide method

The authors report two cases of self-strangulation in which the investigators had initially suspected homicide but eventually deemed the cases to be suicide. Self-strangulation may be mistaken for homicide because it is widely believed to be impossible to carry out this act without assistance. An accurate medicolegal evaluation of the circumstances, a thorough postmortem examination, and methodical inspection of the site are extremely important in such cases. It is equally important to examine the knot or other means used to exert pressure on the neck and to document its position. Finally, to gain a full understanding of these unusual cases, close collaboration between the two different fields, investigative and medicolegal, is essential.