Preservation of Organs

INTRODUCTION

Circumstances and mortuary Preservation:

• When the medical officer suspects the presence of poison by its smell or by some other evidence while conducting autopsy.
• When the cause of death could not be found out after a full autopsy and there is no natural disease or injury
• In decomposed bodies,  In Spot death in burns ,When an investigating officer requests so.
• The body should be stored averagely at 40C.
• The body should be never undressed before the forensic doctor has seen it.
• The body can be stored at 200C to preserve it for long duration.

Routine Viscera Preserved

• Stomach with its contents and proximal 1/3rd (30 cms) of the intestine with its contents.
• Half of each kidney and 500 gm. of liver.
• Liver is the most important tissue because it concentrates many substances.
• Heart- Strychnine, Digitalis.
• Brain- Neurotoxic poisons, alkaloids, volatile organic poisons. Preservation of brain is not required in Heavy metal poisoning.
• Bile- Narcotic drugs, cocaine, methadone, Glutathione, Barbiturates, Tranquilizers, Opiates.
• Lung- Gaseous poison, HCN, Alcohol, Chloroform.
• Vitreous Humour- Alcohol, Chloroform. (Vitreous Humour is preserved by keeping at 4ºC for 48 hours; normally preservative is of no value. Though could be preserved with sodium fluoride)
• Bone- Arsenic, Antimony, Thallium, Radium.
• Uterus- Chemical Abortion
• Skin- Hypodermic injections, snake bite, Corrosives.
• Hair:-  (20-30  in  number or 5 gm), Nails- Heavy Metal Poisoning. Subacute and chronic poisoing  by  heavy metals e.g. arsenic, antimony,  radium,  thallium
• Spinal Cord- Strychnine Poisoning
• CSF- Alcohol intoxication (in 10 mg NaF/ml of fluid)
• Urine- Narcotics, Alcohol, barbiturate  and  opium.
• Body Fat- Endrin , DDT(Organo Chlorines).  (10  gm  from  abdomen  or  perinephric  region)  :  Pesticides  and insectisides  (e.g. organophosphates  poisoning).
• Muscle- When internal organs are badly putrefied.
• Collection of  BLOOD : At least 10 ml collected in a bottle, preferably from peripheral site such as neck, arm & leg and also from subclavian vessels ? C.S.F. : From cisternal puncture , base of brain & puncture of lateral ventricles ? BONE
• MARROW : from sternum, ileum, femur & vertebrae ? URINE : from suprapubic puncture. ? MUSCLES : especially thigh muscles.
• BONE : 200 gm. Or 10cm, conventionally from shaft of femur till mid shaft ? NAILS : removed from their nail bed ? SKIN : a piece of 2.5 cm sq. from the affected area in case of corrosive poisoning and a control is also preserved from the opposite side of the body.

Preservatives  for  specific  poisons

• Saturated  sodium  chloride:  In  all  cases  ofpoisoning  excluding  corrosive acids,  except  carbolic  acids  (phenol),  alkalis, corrosive  sublimate  and  aconite.
• 30  mg  potassium  oxalate  (anticoagulant)  and  10  ml sodium fluoride (enzyme  inhibitor): Blood in  suspected poisoning  including  alcohol  but excluding  oxalic  acid,  ethylene  glycol,  fluoride,  carbon  monoxid.
• Rectified  spirit  :  All  except  in  cases  of poisoning  by phenol, phosphorus, paraldehyde, kerosene, formaldehyde,  formic  acid,  alcohol,  acetic acid, chloroform,  chloral  hydrate, ether.
• Glycerine :  Specimen for  virological examination.
• I0  mg/ml Na/K, fluride and  3 mg K-oxalate: For preserving  blood;  fluride  is  also  added  to  CSR vitreous humor, and urine  if  alcohol estimation  is  required;  and  also  in  analysis of  cocaine,  cyanide  and carbon  monoxide.