Unusual autopsy finding: Simon's bleeding

Abstract

Objective: To determine whether or not hanging had taken place before or after the death of the victim is quite important in the identification of criminal cases pretended to be suicidal attempts.

Material and Methods: Evidence for Simon's bleeding was searched in cases included in the study group after retracting soft tissue and organs away from the field of interest for full exposure of the region of lumbar spinal veretebrae without macroscopic grading of the severity of bleeding, and determining the lumbar level of bleeding. The cases autopsied in Bursa Morgue Department between 2009 and 2011 were retrospectively investigated and evaluated.

Results: A total of 848 cases (664 males, and 184 females, male/female ratio, 3.6 :1) were included in the study. A total of 270 (31.8 %) cases had Simon's bleeding. A significant difference in the frequency of Simon's bleeding exists among various causes of death. A 28.5 % (n = 77) of the cases with Simon's bleeding were in the group with hanged death cases (p < 0.001).

Conclusion: Splinter bleedings identified originally by Simon on the ventral, and later dorsal aspects of the spinal disci in cases of hanging were also observed later in deaths not related to hanging, however it was concluded that these types of bleeding could not be detected in cases of postmortem hanging. When we evaluated all groups, the results we obtained do not support the assertion that the incidence of Simon's bleeding decreases with aging. Instead, when compared with all other groups, the incidence of Simon's bleeding was also higher in cases of hanging with the highest mean age.