Rektale Blutungen beim Erhängen – seltene Befunde mit Verwechslungsgefahr

In the postmortem examination of deceased persons found hanged special importance is attached to proving the vitality of the hanging and ruling out the involvement of a third party; however, in some cases the position of the body may result in postmortem findings that may be difficult for autopsy examiners to interpret. For example, rare cases of rectal hemorrhages with mucosal tears have been described in the literature which may be misinterpreted as the results of sexual acts. The cases of two young men, each found dead in a sitting position hanging from a doorknob, are reported. Both police and forensic postmortem examinations revealed rectal blood staining and findings that initially suggested anal penetration which may also have been forcible. During the forensic dissections performed, it was determined that these findings were caused by pronounced rectal blood stasis. In addition, one body showed hemorrhages of the small intestinal wall and of a testis. Both the macroscopic and histologic findings are presented and discussed in conjunction with the finding situation and the cases already described in the literature.