Fatal Abdominal Stabbing: A Confusing Picture in Differentiating Homicide and Suicide

Background: Differentiating between homicide and suicide can be difficult and even impossible. In this report, we presented a fatal stabbing injury, which made a challenge in the verification of the manner of death.Case Report: A 45yearold man was found dead in his workplace with a knife beside him. His mouth was closed with a scarf, his clothes were intact, and no evidence of a struggle was observed in the scene investigation. There was a vertical stab wound on the midline of the victim’s belly and his intestines were tangled out of the wound. In the autopsy, no defense wound was found. There was blood in the abdominal cavity and retroperitoneal region and several perforations were observed in the intestine and liver along the superficial wound. Painful death and torturous extraction of visceral organs resembled homicide, but nothing indicative of hostility and homicide was found by the forensic exploration and police investigation. Finally, the manner of death was assigned as suicide and the cause of death was a hemorrhagic shock as a result of sharp force injuries.Conclusion: This case represents a bizarre suicide, which is rare and highly suspicious of homicide. In such mysterious cases, the evidence of autopsy and crime scene and police investigation should be regarded to make a decision.