Autopsy: Procedure

Autopsy: Procedure


Important Facts

  • Depending on type of case, any of the body cavity can be opened first
  • Spinal cord is routinely not opened
  • In cases of death due to asphyxia (especially hanging and strangulation), neck should be opened last
  • Spinal cord can be approached either from posterior (most preferred) or anterior approach
  • High cervical spine injuries are best seen by posterior and thoracic spine by anterior approach.
  • Blood for the sample is taken from femoral vein
  • The jugular or subclavian veins can also be used.
  • 10-20 ml of blood is taken and it is taken before autopsy.
  • 30 ml of blood should be preserved (minimum is l0ml)

Skin incison

  1. ‘I’ shaped from the chin to symphysis pubis.
  2. ‘Y’ shaped incision from acromial process down below the breast to xiphoid and down to the symphysis pubis.
  3. Modified ‘Y’ shaped incision- 
  • Incision made in the midline from supra sternal notch to the symphysis pubis.
  •  The incision extends from the suprasternal notch over the clavicle to its centre on both sides and then passes upwards over the neck behind the ear.

Method of removal of organs

VIRCHOW’S TECHNIQUE

  • Individual organs are removed one by one
  • Cranial cavity exposed first, followed by thoracic, cervical and abdominal cavities 

ROKITANSKY’S TECHNIQUE

  • In-situ dissection, combined with en block removal
  • In bodies with highly transmissible diseases like HIV, hepatitis B 

LETULLE’S TECHNIQUE

  • En masse removal of cervical, thoracic, abdominal and pelvic organs and dissected as organ block
  • Advantage – all attachments are intact 

GHON’S TECHNIQUE

  • Cervical, thoracic, abdominal and pelvic organs are removed as organ blocks 

AIR EMBOLISM

  • Head should be opened first and the surface vessels of brain examined for gas bubbles
  • Left ventricle is filled with froth if air is present in sufficient quantity to cause death
  • Pericardial sac opened and filled with water. Right heart is punctured with a scalpel and twisted -air bubbles escape in cases of air embolism
  • Pyrogallol test: Air is brought in contact with alkaline Pyrogallol solution, which turns brown -indicates antemortem air embolism
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