Citation

Pollanen MS. Forensic Sci. Med. Pathol. 2016; 12(2): 170-173.

Affiliation

Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada. Michael.Pollanen@ontario.ca.

Copyright

(Copyright © 2016, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s12024-016-9752-6

PMID

26888609

Abstract

PURPOSE: Reverse hanging (also known as "strappado" or Palestinian hanging [so labeled because this punishment was used by Europeans against locals during the Crusades]) is a form of positional torture where the victim is suspended for a prolonged period of time by the wrists, after the wrists are bound at the back. This leads to a very intense pain and probable dislocation of the arms / shoulders. We report the first autopsy case of reverse hanging. We have discovered that fatal myoglobinuric renal failure due to rhabdomyolysis can be a complication of reverse hanging.

METHOD: An adult detainee, who underwent interrogation by authorities, was admitted to hospital from a prison and died in hospital after a few days. Death was due to myoglobinuric renal failure. An autopsy was performed.

RESULTS: At autopsy, the body showed anasarca due to renal failure. There were healing ligature marks on the wrist and forearm, but no blunt impact injury to the shoulders or arms. There was extensive necrosis of the pectoralis major, biceps, and deltoid muscles, organizing hemoarthrosis of the right glenohumeral joint and hemorrhage into the joint capsule of the both glenohumeral joints. The kidneys showed evidence of myoglobin deposition grossly. The overstretching of the major muscles of the shoulder, in response to the prolonged Palestinian hanging, gave rise to the muscle necrosis.

CONCLUSION: This case underscores the importance of conducting autopsies on people who die in custody, particularly if detained at times of political instability when torture may be practiced by state actors and others. This case also reveals that fatal rhabdomyolysis can occur by positional torture in a stress position, despite the absence of direct trauma due to blunt impacts.

Language: en