A 26-year-old man is found alone in his locked bedroom, suspended by a noose from a door hook. The ligature is padded with a soft towel at the front of the neck, a stack of books lies overturned beneath his feet, and pornographic material and female undergarments are present nearby. There is no suicide note. The most appropriate conclusion is:

• A Suicidal hanging
• B Accidental death during autoerotic asphyxial practice ✓
• C Homicidal ligature strangulation staged as hanging
• D Sexual sadism murder by an unknown assailant

Explanation

Autoerotic asphyxia is accidental death from transient cerebral hypoxia used to enhance sexual gratification. Diagnostic scene features include solitary locked location, padding of the ligature to avoid visible marks, a slipknot or release mechanism, props allowing the victim to relieve pressure (the book stack here), and pornographic or fetish material. Homicidal staging lacks these self-protective devices, and a genuine suicide note or intent is characteristically absent in this scenario.

Reference: Knight's Forensic Pathology, 4th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.