The term “complex suicide” was used for the first time by Marcinkowski et al. in 1974 and it defines rare forms of suicide in which more than one method is used to induce death, unlikely from “simple suicides” where only one technique is involved. According to the different combinations reported in literature, complex suicides have been classified into “typical” (where two common suicide-methods are associated) and “atypical” (where more than two methods, or infrequent combinations of two suicide methods are involved).
In the following case an elderly man suffering of depression was found in the shack of his house with a knife embedded in abdomen and two plastic bags fastened around his neck with a twine. Three other superficial stab wounds were clustered in the upper-left abdomen, close to the penetrating lesion. Internal examination revealed haemorrhagic infiltration at the omentum and haemoperitoneum, whereas no evident signs of asphyxia were highlighted. The cause of death was ascribed to haemorrhagic shock. Features of the crime scene and of the tools used to commit to suicide have been studied. External and internal lesions have been also examined according to the current literature. The outcome of the analysis revealed that this association of suicide methods is unusual, confirming that complex suicides represent a challenging investigation for the forensic pathologist.
