Manner of Death

Most deaths due to stab wounds are homicides. In such killings, multiple wounds are usually widely scattered over the body. Most of the wounds often fail to penetrate deeply and, thus, are not life threatening. Most life-threatening wounds involve the chest and abdomen. Death is usually fairly rapid and due to exsanguination.

Suicide by stabbing is uncommon. When individuals decide to stab themselves, they will often unbutton or pull aside their clothing to expose the area that they intend to stab. Most suicidal stab wounds involve the mid and left chest and are multiple in number, with many wounds showing minimal penetration or just barely breaking the skin (Figure 7.16(A)). The latter are "hesitation" stab wounds. Suicidal stab wounds vary in size and depth with usually only one or two "final" stab wounds going through the chest wall, into an internal organ. Occasionally, a knife will be plunged into the body without any evidence of hesitancy (Figure 7.16 (B)). In some instances, the knife is left in situ. In one case the authors are aware of, an individual stabbed himself with two knives and left them embedded in his abdomen.

Once connected with the traditions of Japanese Samurai warriors, seppuku (commonly called hara-kiri) is an unusual form of suicide involving an

Figure 7.16 (A) Multiple suicidal stab wounds of chest with only one penetrating into chest cavity. (B) Single stab wound to the left chest with knife embedded in chest

Figure 7.16 (A) Multiple suicidal stab wounds of chest with only one penetrating into chest cavity. (B) Single stab wound to the left chest with knife embedded in chest

Chest Stab Wound

abdominal stab wound. A single large wound is inflicted in the abdomen. The sudden evisceration of the internal organs results in an immediate decrease of intra-abdominal pressure and cardiac return, which results in sudden cardiac collapse. The proper method for performing seppuku involves plunging a short sword into the left side of the abdomen, drawing the blade across to the right side of the abdomen and then turning it upward, producing an L-shaped cut.

Impaling injuries are very uncommon. When they do occur, they are usually caused by falls and traffic accidents. Rarely, one encounters deliberate sexually motivated impalement, usually involving the anus and genital area. Occasionally, individuals fall on an object that they are carrying, e.g., a pencil. More commonly, individuals fall or jump from a structure onto a pointed object such as a fence.3 Falling pipes and metal rods have also impaled individuals. In traffic accidents, a vehicle might crash into an obstacle, e.g., a fence, which, in part or in whole, is driven into the car (usually the windshield), impaling the driver or a passenger (Figure 7.17). Shifting cargo, e.g., metal pipes, in the back of a vehicle can slide forward and impale the driver or passenger if the vehicle abruptly stops. Rare cases have been reported involving wood splinters in a tornado.

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