An Atypical Disease-Knowledge-Related Suicide by Means of Slashing the Hemodialytic Arteriovenous Fistula

A case of suicide committed by self-cutting the arteriovenous fistula in a patient on hemodialysis is presented. 77-year-old man was found dead with blood-stained kitchen knife bedroom his daughter. The suffered from severe chronic renal failure, for which he needed hemodialysis. Moreover, recently diagnosed bladder cancer relapse. At autopsy, there single incised wound anterior surface left forearm, showed regular slash skin and subcutaneous tissues. After dissection, small-sized lesion affecting wall. Furthermore, faint postmortem lividity diffuse visceral pallor were observed. Consequently, cause death identified as an acute hemorrhagic shock after self-cut hemodialytic fistula. This worthy several medicolegal considerations: firstly, autopsy examination should always be required cases atypical injuries, providing important data to differentiate suicides homicides. Secondly, disease-knowledge-related are emerging phenomenon, deserve careful analysis. Lastly, it identify patients diseases whom psychological support needed, preventing suicidal ideation reducing risk.