Autopsy (Post Mortem Examination, Obduction)

1 What is an Autopsy (Post Mortem Examination, Obduction)?

An autopsy (also called post-mortem examination or obduction) is the examination of the body of a dead person which is performed primarily to determine the cause of death, to identify or characterize the extent of disease states that the person may have had, or to determine whether a particular medical or surgical treatment has been effective.

Sometimes, in academic institutions, autopsies are also requested for teaching and research purposes and to determine if death was an accident, homicide, suicide, or a natural event (forensic autopsies).

Autopsies are performed by pathologists; medical doctors who have received specialty training in the diagnosis of diseases by the examination of body fluids and tissues. The extent of an autopsy can vary from the examination of a single organ such as the heart or brain to a very extensive examination.

Probably considered by most pathologists as the standard autopsy are an examination of the chest, abdomen, and brain. The autopsy begins with a complete external examination, the weight and height of the body are recorded, and identifying marks such as scars and tattoos also are recorded.

Then, a Y or U- shaped incision is created from both shoulders joining over the sternum and continuing down to the pubic bone. The skin and underlying tissues are then separated to expose the rib cage and abdominal cavity. The front of the rib cage is removed to expose the neck and chest organs.

This opening allows the trachea (windpipe), thyroid gland, parathyroid glands, esophagus, heart, thoracic aorta and lungs to be removed. Following removal of the neck and chest organs, the abdominal organs are cut (dissected) free.

These include the intestines, liver, gallbladder and bile duct system, pancreas, spleen, adrenal glands, kidneys, urethra, urinary bladder, abdominal aorta, and reproductive organs.

An incision is made in the back of the skull from one ear to the other to remove the brain. The scalp is cut and separated from the underlying skull and pulled forward and the top of the skull is removed using a vibrating saw. The entire brain is then gently lifted out of the cranial vault. The spinal cord may also be taken by removing the anterior or posterior portion of the spinal column.

The organs are first examined by the pathologist to note any changes visible with the naked eye. After the organs are removed from the body, they usually are separated from each other and further dissected to reveal any abnormalities, such as tumors, on the inside. Small samples are typically taken from all organs to be made into slide preparations for examination under a microscope.

At the end of an autopsy, the incisions made in the body are sewn closed. The organs may be returned to the body or may be retained for teaching, research, and diagnostic purposes. The performance of an autopsy does not interfere with an open casket funeral service, as none of the incisions made in order to accomplish the autopsy are apparent after embalming and dressing of the body by the mortician.

After an autopsy, a detailed report is prepared that describes the autopsy procedure and microscopic findings, gives a list of medical diagnoses, and a summary of the case. The report emphasizes the relationship or correlation between clinical findings (the doctor's examination, laboratory tests, radiology findings, etc.) and pathologic findings (those made from the autopsy).