Pattern and Clinicopathological Profile of Violent Asphyxial Deaths in a Hilly Region: A Two-Year Retrospective Descriptive Autopsy Study

Background: Asphyxial deaths represent a major portion of medicolegal autopsy cases. These can occur due to hanging, wet drowning or strangulation. The mode of asphyxial death is dependent on several factors including geographical location, environmental conditions, demographic characteristics etc. For instance, in hilly areas, availability of natural water resources and scattered population may affect the incidence of certain types of asphyxial deaths. Material and Methods: In this retrospective descriptive study, we studied all the cases of violent asphyxial deaths that were brought to our department of forensic medicine, which is situated in a hill station over a period of two years (Jan. 2024 – Dec. 2025). We collected data from the postmortem reports and analyzed it with regard to the type of asphyxia, age of the victim, sex of the victim, manner of death, seasonality, autopsy findings etc. Results: We analyzed 50 cases. Of them, 27 (54%) were hanging cases; 20 (40%) were wet drowning cases and 3 (6%) were strangulation cases. Out of all the cases studied, majority were male and maximum numbers fell into the age category of 21–40 years. Most of the hanging cases were suicides and majority of wet drowning cases were accidents. Wet drowning was found to be increased significantly during the months of summer and monsoon. Commonly used ligature material was easily available household articles. Classical ligature marks were observed in majority of hanging cases but internal neck injuries were rare. Conclusion: The present study highlights that the pattern of violent asphyxial deaths in the hill stations is affected by both environmental as well as social factors. Hanging continues to remain the most common type of asphyxial death in hilly stations and the incidence of wet drowning varies significantly throughout different seasons. Therefore, careful autopsy examination, especially in case of hangings is mandatory for finalizing the cause and manner of death. Preventive measures specifically designed according to local environment may help in reducing the occurrence of such fatal events.

Keywords: Violent asphyxia, Hilly region, Seasonal variation, Ligature mark, Medicolegal investigation.