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Difference between revisions of "Autopsy"
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'''Autopsy''' was once a mainstay of [[pathology]]. It is now in decline and uncommonly done. Fetal autopsy is dealt with in a separate article called ''[[fetal autopsy]]''. | '''Autopsy''' was once a mainstay of [[pathology]]. It is now in decline and uncommonly done. Fetal autopsy is dealt with in a separate article called ''[[fetal autopsy]]''. | ||
==Autopsy checklist | =Value of autopsy= | ||
A significant number of major findings cannot be diagnosed without histology;<ref name=pmid16324191>{{Cite journal | last1 = Roulson | first1 = J. | last2 = Benbow | first2 = EW. | last3 = Hasleton | first3 = PS. | title = Discrepancies between clinical and autopsy diagnosis and the value of post mortem histology; a meta-analysis and review. | journal = Histopathology | volume = 47 | issue = 6 | pages = 551-9 | month = Dec | year = 2005 | doi = 10.1111/j.1365-2559.2005.02243.x | PMID = 16324191 }}</ref> thus, without a biopsy or an autopsy they cannot be diagnosed. Autopsies can be regarded as a form of [[quality control]]. | |||
One large review in ''JAMA'' suggests that approximately:<ref name=pmid12783916>{{cite journal |author=Brian Gallagher, Burton EC, McDonald KM, Goldman L |title=Changes in rates of autopsy-detected diagnostic errors over time: a systematic review |journal=JAMA |volume=289 |issue=21 |pages=2849–56 |year=2003 |pmid=12783916 |doi=10.1001/jama.289.21.2849}}</ref> | |||
* 25% of autopsies reveal a finding that would have changed clinical management. | |||
* 5% of autopsies reveal a missed [[diagnosis]] that probably affected the outcome. | |||
=Autopsy checklist= | |||
===Minimum to proceed=== | ===Minimum to proceed=== | ||
*Death certificate complete. | *Death certificate complete. | ||
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**Expected versus unexpected. | **Expected versus unexpected. | ||
=Autopsy consent= | |||
===General=== | ===General=== | ||
*In a hospital autopsy the ''most important'' thing is: ''proper consent''. | *In a hospital autopsy the ''most important'' thing is: ''proper consent''. | ||
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|} | |} | ||
=External exam= | |||
===General=== | ===General=== | ||
*Very important in the forensic context. | *Very important in the forensic context. | ||
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*External exam findings are found in the ''[[forensic pathology]]'' article. | *External exam findings are found in the ''[[forensic pathology]]'' article. | ||
=Internal exam= | |||
===General=== | ===General=== | ||
*This is usually where the money is in hospital autopsies. | *This is usually where the money is in hospital autopsies. | ||
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***May be associated with blood vessel tortuosity.<ref>KC. 14 September 2010.</ref> | ***May be associated with blood vessel tortuosity.<ref>KC. 14 September 2010.</ref> | ||
=Histology= | |||
===General=== | ===General=== | ||
It's the at the pathologists discretion. In ''decomp'' cases it is reasonable to submit nothing. | It's the at the pathologists discretion. In ''decomp'' cases it is reasonable to submit nothing. | ||
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*Muscle. | *Muscle. | ||
*[[Lymph nodes]]. | *[[Lymph nodes]]. | ||
=Autopsy report= | |||
==Normal size parameters== | |||
===Normal organ masses (adult)=== | |||
Caucasoid population of 684 adults:<ref name=pmid11376980>{{cite journal |author=de la Grandmaison GL, Clairand I, Durigon M |title=Organ weight in 684 adult autopsies: new tables for a Caucasoid population |journal=Forensic Sci. Int. |volume=119 |issue=2 |pages=149–54 |year=2001 |month=June |pmid=11376980 |doi= |url=}}</ref> | |||
{| class="wikitable" | |||
| | |||
|'''Men''' | |||
|'''Women''' | |||
|- | |||
|'''Heart''' | |||
|365 +/- 71 g | |||
|312 +/- 78 g | |||
|- | |||
|'''Right lung''' | |||
|663 +/- 239 g | |||
|546 +/- 207 g | |||
|- | |||
|'''Left lung''' | |||
|583 +/- 216 g | |||
|467 +/- 174 g | |||
|- | |||
|'''Liver''' | |||
|1677 +/- 396 g | |||
|1475 +/- 362 g | |||
|- | |||
|'''Spleen''' | |||
|156 +/- 87 g | |||
|140 +/- 78 g | |||
|- | |||
|'''Right kidney''' | |||
|162 +/- 39 g | |||
|135 +/- 39 g | |||
|- | |||
|'''Left kidney''' | |||
|160 +/- 41 g | |||
|136 +/- 37 g | |||
|} | |||
===Pediatrics=== | |||
{{Main|Growth charts}} | |||
==Negative autopsy== | ==Negative autopsy== | ||
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*[[Sudden infant death syndrome]]. | *[[Sudden infant death syndrome]]. | ||
=See also= | |||
*[[Fetal autopsy]]. | *[[Fetal autopsy]]. | ||
*[[Forensic pathology]]. | *[[Forensic pathology]]. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
=External links= | |||
[[Category:Autopsy]] | [[Category:Autopsy]] | ||