Chapter 14: Postmortem Examination

**Postmortem examination**

most commonly known as *autopsy,* is a scientific and systemic study of a dead body.

Clinical/Pathological/Academic Autopsy

To determine the disease causing death.

Medicolegal Autopsy

To solve mysterious unnatural death.

Anatomical Autopsy

• To learn the normal structure of the human body by medical students.

• It is usually done on an unclaimed dead body, handed over to anatomy department by municipal or such other governmental authority.

**medicolegal autopsy**

A **________** is a special type of autopsy or postmortem examination, ordered by the government/legal authorities in all unnatural deaths, such as homicide, suicide, accident, etc.

**Authorisation order**

**_____** is usually in the form of requisition letter, which must be received by the doctor prior to autopsy and it depends on type of the case.

**Technique of R Virchow**

Organs are removed one by one. Here the cranial cavity is opened first, then spinal cord, followed by thoracic, cervical and abdominal organs in that order.

**Technique of C Rokitansky**

This is characterised by ‘in situ’ dissection, in part, combined with removal of organ blocks.

**Technique of A Ghon**

Thoracic and cervical organs, abdominal organs, and the urogenital systems are removed or organ block.

**Technique of M Letulle**

Cervical, thoracic, abdominal and pelvic ogans are removed as one organ mass and subsequently dissected into organ blocks.

**I-Shaped Incision**

Extends from symphysis menti to symphysis pubis taking curve towards left around umbilicus.

**Y-Shaped Incision**

Commence at angle of mandible above on either side and the incision from both sides brought forwards, downwards to meet at the suprasternal notch and then run downwards as in “I” shape incision to symphysis pubis.

**Modified Y-Shaped Incision**

Commences at anterior axillary fold on the chest on either side, runs downwards and anteriorly beneath the breasts as to meet at xiphisternum in the midline and then run downwards as in I-shaped incision to symphysis pubis.

**Elongated X-shaped Incision**

This is a aspecial incision used to dissect out subcutaneous structures in the back to identify and evaluate the extent of blunt injuries, which are usually missed where superficial imprints are faint, particularly when present on skin not overlying bone.

**Negative autopsy**

an autopsy, which fails to reveal the cause of death with gross, microscopic, toxicologic and other laboratory investigations.

Obscure autopsy

 an autopsy done meticulously, properly and perfectly, but may present with no clear-cut findings as to give a definite cause of death, leading to perplexity of the forensic pathologist

**Hydrostatic test**

a test done to confirm whether the lungs tested are from a respired newborn or not.

**Breslau’s Second Life Test**

A test done to determine whether the child was born alive or not.

**Live Born Child**

partly or wholly born external to the mother and showed some signs of life. It is found out by the presence of certain well-defined changes that occur in the body after birth and known as “signs of live birth.

**Dead born child**

died in the uterus long before labor started. It is diagnosed by the presence of maceration

**Stillborn Child**

After being born the child never showed any sign of life. It might have died during delivery.

**second autopsy**

After the first autopsy (Postmortem examination) when a repeat medicolegal postmortem is performed with the authorisation by law it is called **_______**.

**Artifacts**

any change or alteration, which is man-made as a whole or introduced in the natural state of the body is likely to be misinterpreted at autopsy.

**Psychological autopsy**

• It is a recently developed postmortem investigative tool that aids in the determination of a person’s cause of death.

• It is used most often in cases of suspected suicide or homicide. It has a definite role in criminal investigations.

Interviews with eyewitnesses

These interviews are usually conducted with persons who witnessed the actual death event and/or persons who found the deceased’s body.

Interview with character witnesses

These are persons who were related to, or acquainted with, the deceased in some or other way, such as family, friends and co-workers

Structured Interview of Reported Symptoms (SIRS)

It can help detect malingering.

Murder investigations

The results can reveal vital information about why the victim was chosen by the killer. This may help to detect similarities between different crimes committed at different times, possibly enabling detectives to pinpoint a criminal’s signature.

Suicide investigations

Psychological autopsies are mostly indicated in cases of suspected suicide. This is sometimes the only way to shed light on the characteristics of suicide victims, and to identify the possible warning signs that may have been present prior to their self-demise.