Asphyxia is a critical pathological condition resulting from impaired oxygen supply to tissues, leading to systemic hypoxia and cellular injury. Strangulation and drowning represent two major forms of mechanical asphyxia commonly encountered in forensic practice. Each form produces characteristic pathoanatomical changes that reflect both the mechanism and duration of hypoxia. This article analyzes the macroscopic and microscopic pathological alterations observed in cases of strangulation and drowning, emphasizing their diagnostic significance in forensic pathology. Understanding these changes is essential for determining cause of death, vitality, and the circumstances surrounding fatal asphyxial events.

asphyxia, strangulation, drowning, forensic pathology, hypoxia, pathoanatomy.

Knight B., Saukko P. Knight’s Forensic Pathology. 4th ed. Boca Raton: CRC Press; 2016.

DiMaio V.J.M., DiMaio D. Forensic Pathology. 2nd ed. Boca Raton: CRC Press; 2001.

Spitz W.U., Spitz D.J., Fisher R.S. Spitz and Fisher’s Medicolegal Investigation of Death. 5th ed. Springfield: Charles C Thomas; 2011.

Dolinak D., Matshes E., Lew E. Forensic Pathology: Principles and Practice. Amsterdam: Elsevier Academic Press; 2005.

Payne-James J., Byard R., Corey T., Henderson C. Encyclopedia of Forensic and Legal Medicine. 2nd ed. Oxford: Elsevier; 2016.

Byard R.W. Asphyxial deaths and petechial hemorrhages. Forensic Science, Medicine, and Pathology. 2015;11(3):417–421.

Saukko P., Knight B. Suffocation and strangulation. In: Knight’s Forensic Pathology. CRC Press; 2016: 352–376.

Pollanen M.S., Chiasson D.A. Pathology of hypoxic–ischemic injury. Forensic Science International. 1996;79(2):135–146.

Madea B. Estimation of the Time Since Death. 3rd ed. London: CRC Press; 2015.

Piette M.H.A., De Letter E.A. Drowning: still a difficult autopsy diagnosis. Forensic Science International. 2006;163(1–2):1–9.

Lunetta P., Smith G.S., Penttilä A., Sajantila A. Unintentional drowning in Finland. International Journal of Epidemiology. 2004;33(5):1053–1063.

DiMaio D. Petechial hemorrhages in asphyxial deaths. American Journal of Forensic Medicine and Pathology. 1989;10(3):201–205.

Byard R.W., Houldsworth G., James R.A., Gilbert J.D. Laryngeal fractures in manual strangulation. Journal of Forensic Sciences. 2000;45(3): 620–626.