Detailed Note on Autopsy Procedure

An autopsy is a surgical procedure to examine a corpse by dissecting the body. It is also known as necropsy or postmortem examination. An autopsy is done to determine the cause, mode, and manner of death. It also helps to evaluate any disease or injuries. Autopsies are also done for research and educational purposes.

The term autopsy is derived from the Greek word ‘autopsia’ which means “the act of seeing oneself”. Autopsies can be done by a medical doctor known as a pathologist or by a registered medical practitioner.  

For conducting an autopsy along with a well-equipped mortuary, instruments and chemicals are also required. After the examination, an autopsy report is made which will have an introductory part, an examination part that mentions the findings, and finally the conclusion/opinion which explains the cause of death deduced from the autopsy findings.

The autopsy can be either clinical or medicolegal. A clinical autopsy is known as a pathological autopsy or academic autopsy and a medicolegal autopsy is also known as forensic autopsy. Rules and procedures should be followed while conducting an autopsy.

In a forensic autopsy, the autopsy is always complete but in a clinical autopsy, it can be complete or incomplete depending upon the consent. Both external and internal examination is required to collect evidence, analyze, assess and determine the cause of death.

Autopsy Examination of a Dead Body

External Examination of a Corpse

• The clothes are examined for the presence of any stains, foreign material, sand, cut marks, stab marks, loss of a button, etc.
• If the body is known, then the police constable accompanying the body should identify the body. If it is feasible then the relatives should be asked to identify and if it’s an unknown body, then any two identification marks should be recorded like a mole, tattoo, scar, fingerprint, etc.
• The investigating officer will have the photographs and fingerprints of the body.
• Overall appearance of the person like height, weight, gross deformities, hair pattern, etc. is noted.
• Examines if the body can be identified or is it swelled, bloated, distorted.
• Changes after death such as the presence or absence of rigor mortis and its distribution are noted. The site, color, appearance of postmortem lividity is noted.
• Skin and body should be checked for dermatological lesions.
• Perceive for any odor emitting from the body like the smell of kerosene, insecticide, and so on.
• Check for the presence or absence of signs of decomposition.
• Collect the entomological evidence also.
• Check for any injuries and if present document them. It should be noted sequentially like starting from head to toe. Mention the size, site, dimension, orientation, shape.
• Note the state of natural orifices such as nose, mouth, ear, anus, vagina, urethra for the presence of any foreign body, injury, or disease.
• Also, check the external genitals if sexual assault is suspected.

Internal Examination of a Corpse

• Internal examination is done by dissecting and examining the cranial cavity, thoracic cavity, abdominal cavity, dissection of the spinal cord (when required), dissection of extremities(when indicated).
• In a fetus generally, the abdominal cavity is opened first to record the position of the diaphragm.
• If the probable cause of death is known then open the cavity based on that.
• The autopsy can be done using different techniques like the technique of Virchow, the technique of Rokitansky, the technique of ghon, technique to letulle.
• There are different incision types also based on the region that is being examined, a suitable incision is made.
• If the cranial cavity is being examined, then a coronal incision is made which will reflect the scalp. The skull cap is removed by sawing through the bones. The skull vault is examined for any fracture or hematoma, the dura is examined for any collection of blood, injury, or disease. Superior sagittal sinus is examined for the presence of thrombosis.
• The brain is examined for the presence of any injury, disease, vascular malformation, or aneurysm. The ventricular system is also examined.
• On examining the chest and the abdominal cavity, the weight, size, shape, surface, consistency, and color of the organs should be noted. Also check for any injury, disease, pathological lesion, or collection of blood/fluid.
• The spinal cord is opened if any disease, injury is suspected. Also in the case of strychnine poisoning. Either posterior approach or anterior approach can be made to open the spinal cord.
• Required samples are collected for examination. If poisoning is suspected, then viscera and other required articles are preserved.  

CONCLUSION

Autopsy helps to determine the cause, mode, and manner of death. It helps to estimate the time since death and to establish the identity of the deceased if it is unknown. In newborns, it helps to determine whether it was a stillbirth, live birth, or dead birth.

It also helps in research and educational purposes and also to understand the effectiveness of the therapeutic procedures. It helps to confirm the clinical diagnosis. It helps to collect evidence that will help in identifying the criminal thereby delivering justice to the victim.