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Difference between revisions of "Autopsy"
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→Abdominal organ pluck
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==Abdominal organ pluck== | ==Abdominal organ pluck== | ||
===Adrenal glands=== | ===Adrenal glands=== | ||
#Place cuts at anatomical location. | |||
#Take section for stock. | |||
====Common findings==== | ====Common findings==== | ||
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*Cortical adenomas - seen in ~ 2% of autopsies.<ref name=pmid14514341>{{cite journal |author=Barzon L, Sonino N, Fallo F, Palu G, Boscaro M |title=Prevalence and natural history of adrenal incidentalomas |journal=Eur. J. Endocrinol. |volume=149 |issue=4 |pages=273–85 |year=2003 |month=October |pmid=14514341 |doi= |url=}}</ref> | *Cortical adenomas - seen in ~ 2% of autopsies.<ref name=pmid14514341>{{cite journal |author=Barzon L, Sonino N, Fallo F, Palu G, Boscaro M |title=Prevalence and natural history of adrenal incidentalomas |journal=Eur. J. Endocrinol. |volume=149 |issue=4 |pages=273–85 |year=2003 |month=October |pmid=14514341 |doi= |url=}}</ref> | ||
*Metastatic cancer, esp. in the context of lung cancer. | *Metastatic cancer, esp. in the context of lung cancer. | ||
====Others==== | =====Others===== | ||
*Atrophy. | *Atrophy. | ||
*Hyperplasia (bilateral). | *Hyperplasia (bilateral). | ||
*Hemorrhage (Waterhouse-Friderichsen syndrome). | *Hemorrhage (Waterhouse-Friderichsen syndrome). | ||
===Stomach=== | |||
*Opened along greater curvature. | |||
*GE junction should not be opened if portal hypertension is suspected (see: ''esophagus''). | |||
====Findings==== | |||
*Haemorrhage = usu. post-mortem. | |||
*Small ~1 mm pellets ([http://www.gea-pharma.in/GPSIN/cmsresources.nsf/0/0514D214E17B10C0C125749B002640E1/$File/capsule_type.jpg medicinal capsule contents]). | |||
===Esophagus=== | |||
*Should be everted, if portal hypertension is suspected, as varices are thus more readily demonstrated.<ref name=Ref_HospAuto140>{{Ref HospAuto|140}}</ref> | |||
*#Stomach opened (''without opening GE junction''). | |||
*#String tied to proximal esophagus. | |||
*#Forceps inserted from stomach to grasp tied end and invert esophagus. | |||
===Omentum=== | |||
*It is a good idea to trim this from the stomach. | |||
===Spleen=== | ===Spleen=== | ||
#Separate stomach from spleen. | |||
#Identify the splenic vessels. | |||
#To separate the spleen from the pluck: | |||
#*Cut across vessels at splenic hilum - close to the spleen. | |||
====Common findings==== | ====Common findings==== | ||
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Notes: | Notes: | ||
*If there is a suspected biliary tract obstruction: | *If there is a suspected biliary tract obstruction: | ||
*#Open the duodenum and identify the ''duodenal papilla'' - this is usually obvious as everything distal to the duodenal papilla is usually light brown (bile-stained). | *#Open the duodenum (from distal end) and identify the ''duodenal papilla'' - this is usually obvious as everything distal to the duodenal papilla is usually light brown (bile-stained). | ||
*#Compress the gallbladder and bile should emerge from the duodenal papilla. | *#Compress the gallbladder and bile should emerge from the duodenal papilla. | ||
*#Disect bilary tree from duodenal papilla to the porta hepatis. | |||
====Common pathologic findings==== | ====Common pathologic findings==== | ||
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*Gall stones. | *Gall stones. | ||
*Mucosa with strawberry-like appearance (cholesterolosis). | *Mucosa with strawberry-like appearance (cholesterolosis). | ||
===Pancreas=== | |||
*Serially section along axis of pancreatic duct. | |||
*Pieces of head & tail for stock ''or'' stock and histology. | |||
==Genitourinary-rectal ''or'' pelvic pluck== | ==Genitourinary-rectal ''or'' pelvic pluck== | ||