Unusual fatal stab wounds - Suicide or homicide? [Todesfall mit ungewohnlichen stichverletzungen - Suizid oder homizid?]

This report presents a fatal case of stabbing involving a 53-year-old female who was suspected to have a depressive disposition. Stab and incision wounds were located on the skull, face, neck, chest, abdomen and wrists and 11 stab wounds in the chest penetrated deep within the thoracic cavity and the mediastinum causing-potentially fatal injuries to the heart and lungs. The multiplicity and the sites of the wounds were thus illustrating the difficulties that may arise in differentiating between suicide and homicide. Some of the traditional criteria of self-stabbing, such as prior exposure of the chest from clothing, preference of the left side (in a right-handed individual) or parallel course of the wound axes were absent. In contrast, tentative marks on the neck and the abdomen as well as the abundance of superficially ending stab wounds indicated self-infliction. Multiple superficial stab wounds on the forehead without any injuries of the tabula externa point to an underlying psychotic disorder. Many of the injuries to the chest and neck were potentially fatal, thus - given the case of self- stabbing-requiring a long sustained capacity of action.