An autopsy is a surgical technique that entails a detailed examination of a body by dissection to determine the cause, mode, and manner of death. It is also referred to as a post-mortem examination, obduction, necropsy, or autopsia cadaverum.
The examination may also be conducted for scientific or educational purposes to evaluate any illness or injury that may be present. Only animal bodies are normally discussed when the word "necropsy" is used.
A pathologist, a specialty doctor, frequently performs autopsies. Only a very small fraction of fatalities, in some cases, require an autopsy. A medical examiner or coroner may typically identify the cause of death.
Autopsies come in two basic categories: forensic and clinical. When a death is suspicious, violent, or from an unidentified cause, the first procedure is carried out. at order to identify and better comprehend the reasons of death, the second is carried out at the hospital by the pathologist with the next of kin's permission.
Types Of Autopsy
Medicolegal Autopsy
M/C type of autopsy in India
Done in unnatural deaths - Suicide, Homicide
Consent from Investigation officer (IO), Police/ Magistrate
Complete autopsy
Body to be handed over to IO
Clinical / Pathological Autopsy
Done in Natural deaths
Relative give consent (cannot be done without consent)
Body to be handover to Relatives
Partial autopsy
Negative autopsy:
Doctor will not be able to state the cause of death.
It may be due to incorrect technique, lack of experience, incorrect preservation etc.
Psychological Autopsy (No Dissection)
Done in suicidal deaths
Done to know about the psychological state of person before committing suicide.
Conduct interviews with parents/ friends.
Different Types of skin Incisions
Following are the different types of skin incisions used for performing autopsy -
“I” Incision
Starting from chin to pubic symphysis
Most commonly used.
“Y” Incision
Starting from shoulders on both sites reach Xiphisternum and it comes down to the pubic symphysis.
Modified “Y” Incision
Starts from mastoid comes down the lateral site of neck and then from suprasternal notch to Pubic Symphysis
Good for neck dissection
Preferred in Asphyxialdeaths.
Inverted “Y” incision
Starts from the chin in midline and comes down at the umbilicus it bifurcates and moves to the respective iliac crest.
“T” incision
Transverse incision starts from one acromion process to other and the vertical incision from suprasternal notch to pubic symphysis.
“X” incision
Put on back of body
Skin is reflected and look for deep contusion
Seen in custodial deaths
Different Techniques of Organ Removal in Autopsy
There are a number of general and specific autopsy techniques. Let’s learn important details on these different techniques below -
Virchow’s Method
One by one removal of organs
M/C method used.
Letulle’s / En mass Method
En-Mass Removal or Evisceration
RAPID method
Also used to study anatomical relation
Removal of attachment of tongue and from there we remove all the thoracoabdominal organs together as a single mass. Then we dissect the organs.
Ghon’s Method
En–bloc Removal
Targets only one particular area.
Ex: In Sexual offence - Only pelvic organs are removed. In Thoracic pathology/ Trauma - Only thoracic organs are removed.
Rokitansky Method
In-situ method
Organ not removed outside the body to avoid spillage and exposure.
Used for infectious diseases.
Example: HIV, Hepatitis patient,Covid pt.
Heart Dissection
Inflow outflow method: Start cutting from RA → RV → LA → LV
Brain dissection
Can be done as Fresh ( commonly done) or Fixation with Formalin (best)
Stomach dissection
Double ligation method
Cut the stomach out by applying two ligatures at the ends and cut in the middle.
The area along lesser curvature has max damage due to poisoning. This is known as Magenstrasse
So, we open our stomachs along greater curvature in poisoning cases.
Spinal cord dissection
Not routinely opened unless we suspect spinal injuries
2 approaches: anterior and posterior.
Posterior is easier and better.
Air embolism
Pyrogalloltest , done to detect air embolism , Brown color indicates positive test
Which cavity to be opened first when starting an autopsy?
Cranium
In poisoning cases
Asphyxial cases to decompress vessels
Thorax
Pneumothorax case to demonstrate presence of air in thorax
Q. In autopsy, the doctor tied the bronchus and checked the floating and sinking of the lung. The test is identified as?
A. Getter’s test
B. Diatoms test
C. Hydrostatic test
D. Ploquet’s test
Answer: Hydrostatic test
Q. In the corrosive acid case, the stomach is opened along? A. Lesser curvature
B. Greater curvature
C. Vertical
D. Pylorus
Answer: Greater curvature
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