Emedinews:Insights on Medicolegal Issues:Autopsy artefacts

When an autopsy is conducted on a body, surgical interventions are made for internal examination that may damage blood vessels and organs, cause skull bone fracture, etc. These are the artifacts of post–mortem examination and absolutely unrelated with the natural state of the dead body. Sometimes it is grossly mistaken especially in cases of repeat autopsy taking place in a different center.

·         Using chisel and hammer to loosen the skull cap may produce additional fractures or may cause extension of an already present antemortem fracture.

·         Rough handling of the brain during removal may produce midbrain tears. If the neck structures are pulled too hard during autopsy, they may be torn.

·         Pulling of the dura in the sagittal line will cause the air to enter the blood vessels at the top of the brain. Due to the reflection of the skin, air may enter the veins of the neck. This may lead to erroneous diagnosis of air embolism.

·         In case of a suspected cranial injury, the body should be opened, and the cardiovascular system decompressed by opening heart before the head is opened.

·         Large blood vessels may be cut while opening the thoracic and abdominal cavities, and considerable amount of blood escapes to the pleural and peritoneal cavities.

·         Air may be drawn back into the circulation and enter coronary vessels and give false impression of air embolism.

·         During autopsy, the handling of organs and incision of vessels may result in extravasation of blood into the tissues.

·         In older persons, the hyoid bones and thyroid cartilage may be fractured while removing the neck organs. Surrounding the fracture regions, hemorrhages are not seen.

·         Osseous union between the segments of hyoid may be unilateral. Such unilateral mobility or artefact by dissection may lead to erroneous impression of an antemortem fracture.

·         While dissecting the neck structures, if toothed dissecting forceps are used, it may damage the intima of the carotid artery which resembles a tear, as seen in case of strangulation.

·         The toxicological artefacts may be introduced due to the contamination of viscera with stomach contents due to autopsy, or by putting all the organs in one container or by using faulty techniques in collecting or storage of samples.

(Ref: Dr. PC Dikshit Head (MAMC) MD LLB, Textbook of Forensic Medicine, Peepee Publisher)