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This decomposed man was found in the prone position, having collapsed to the ground face first near his kitchen table. He had collapsed onto electrical wiring that was extending from his computer and phone to the wall. Note how he had collapsed onto these wires and, in fact, became partially suspended by a telephone cord that passed underneath his neck, keeping his head, neck, and upper body off the ground.

Fig.1 This decomposed man had collapsed to the ground face first near his kitchen table.

At autopsy, note the ligature mark created by the telephone cord that extended roughly horizontally across the front and sides of his neck. Without knowledge of how the body was positioned at the scene, the ligature mark from the telephone cord could be easily misidentified as a ligature mark associated with homicidal strangulation. At autopsy, he had heart disease, and no evidence of internal neck injury.

Fig.2 Note how he had collapsed onto these wires and became partially suspended by a telephone cord that passed underneath his neck.

Certain situations can produce neck findings that may be confused with ligature strangulation. Probably the most common is the bloated decomposed body in which the neck tissues swell to such an extent that they press against a shirt collar or necklace. When the shirt or necklace is removed, one may notice a blanched, horizontal impression extending circumferentially around the neck.

Fig.3 The ligature mark created by the telephone cord.

This should not be confused with an antemortem injury and should be recognized as the body is undressed. Also, overlapping rolls of neck skin can be mistaken for a ligature mark. This can be seen in infants, elderly individuals, and others with abundant neck tissue. Other neck artifacts involve body positions attained during the person’s collapse or activities performed shortly before his or her death.

Fig.4 The ligature mark from the telephone cord could be easily misidentified from homicidal strangulation.

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