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