Question:medium
This is seen in postmortem examination of which type of asphyxia:
This is seen in postmortem examination of which type of asphyxia:
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Where are the injuries \u2014 around the mouth/nose or on the neck? Perioral pressure marks point to closure of the external air passages.
Updated On: Jun 22, 2026
- Throttling
- Smothering
- Hanging
- Garrotting
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The Correct Option is B
Solution and Explanation
Approach this by anatomically localising the postmortem injury, then matching the location to the mechanism of asphyxia.
Localise the finding: The injuries shown lie on and around the mouth and lips (perioral region), not on the neck. In forensic medicine, the site of external pressure points to the type of mechanical asphyxia.
Match the mechanism: Pressure applied over the nostrils and mouth to block air entry is the definition of smothering. The hallmark autopsy findings of smothering are therefore concentrated around the face: abrasions and bruises around the lips and nostrils, and - importantly - contusions or lacerations on the inner surface of the lips, gums and cheeks where soft tissue is crushed against the teeth. This perioral pattern is exactly what the figure illustrates.
Exclude the neck-based asphyxias: Throttling, hanging and garrotting all act on the neck. Throttling leaves nail-mark crescentic abrasions and disc-shaped finger bruises on the neck with possible hyoid/thyroid fracture. Hanging leaves an oblique, interrupted ligature mark riding high above the thyroid cartilage. Garrotting leaves a horizontal, continuous, low ligature mark. None of these explain isolated injuries of the mouth and lips.
Supporting autopsy detail: In smothering, internal findings of asphyxia are also expected - petechial haemorrhages (Tardieu spots) on the face, conjunctivae and visceral surfaces, cyanosis, congestion and a fluid (right-sided) heart - but it is the localised perioral pressure injuries that distinguish it from the neck-based deaths. If a soft pillow or cloth is used, external injuries may even be minimal, making any visible perioral abrasions/contusions especially significant.
Conclusion: The perioral injuries are diagnostic of smothering.
$Answer = B\,(Smothering)$
Localise the finding: The injuries shown lie on and around the mouth and lips (perioral region), not on the neck. In forensic medicine, the site of external pressure points to the type of mechanical asphyxia.
Match the mechanism: Pressure applied over the nostrils and mouth to block air entry is the definition of smothering. The hallmark autopsy findings of smothering are therefore concentrated around the face: abrasions and bruises around the lips and nostrils, and - importantly - contusions or lacerations on the inner surface of the lips, gums and cheeks where soft tissue is crushed against the teeth. This perioral pattern is exactly what the figure illustrates.
Exclude the neck-based asphyxias: Throttling, hanging and garrotting all act on the neck. Throttling leaves nail-mark crescentic abrasions and disc-shaped finger bruises on the neck with possible hyoid/thyroid fracture. Hanging leaves an oblique, interrupted ligature mark riding high above the thyroid cartilage. Garrotting leaves a horizontal, continuous, low ligature mark. None of these explain isolated injuries of the mouth and lips.
Supporting autopsy detail: In smothering, internal findings of asphyxia are also expected - petechial haemorrhages (Tardieu spots) on the face, conjunctivae and visceral surfaces, cyanosis, congestion and a fluid (right-sided) heart - but it is the localised perioral pressure injuries that distinguish it from the neck-based deaths. If a soft pillow or cloth is used, external injuries may even be minimal, making any visible perioral abrasions/contusions especially significant.
Conclusion: The perioral injuries are diagnostic of smothering.
$Answer = B\,(Smothering)$
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