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Autopsy

 

Definition

An autopsy is a postmortem assessment or examination of a body to determine the cause of death. An autopsy is performed by a physician trained in pathology.

Purpose

Most autopsies advance medical knowledge and provide evidence for legal action. Medically, autopsies determine the exact cause and circumstances of death, discover the pathway of a disease, and provide valuable information to be used in the care of the living. When foul play is suspected, a government coroner or medical examiner performs autopsies for legal use. This branch of medical study is called forensic medicine. Forensic specialists investigate deaths resulting from violence or occurring under suspicious circumstances.
Benefits of research from autopsies include the production of new medical information on diseases such as toxic shock syndrome, acquired immunodeficiency syndrome (AIDS). Organ donation, which can potentially save the lives of other patients, is also another benefit of autopsies.

Key terms

Acquired immunodeficiency syndrome (AIDS) — A group of diseases resulting from infection with the human immunodeficiency virus (HIV). A person infected with HIV gradually loses immune function, becoming less able to resist aliments and cancers, resulting in eventual death.
Computed tomography scan (CT scan) — The technique used in diagnostic studies of internal bodily structures in the detection of tumors or brain aneurysms. This diagnostic test consists of a computer analysis of a series of cross-sectional scans made along a single axis of a bodily structure or tissue that is used to construct a three-dimensional image of that structure
Creutzfeld-Jakob disease — A rare, often fatal disease of the brain, characterized by gradual dementia and loss of muscle control that occurs most often in middle age and is caused by a slow virus.
Hepatitis — Inflammation of the liver, caused by infectious or toxic agents and characterized by jaundice, fever, liver enlargement, and abdominal pain.
Magnetic resonance imaging (MRI) — A diagnostic tool that utilizes nuclear magnetic energy in the production of images of specific atoms and molecular structures in solids, especially human cells, tissues, and organs.
Postmortem — After death.

Precautions

When performed for medical reasons, autopsies require formal permission from family members or the legal guardian. (Autopsies required for legal reasons when foul play is suspected do not need the consent of next of kin.) During the autopsy, very concise notes and documentation must be made for both medical and legal reasons. Some religious groups prohibit autopsies.

Description

An autopsy can be described as the examination of a deceased human body with a detailed exam of the person's remains. This procedure dates back to the Roman era when few human dissections were performed; autopsies were utilized, however, to determine the cause of death in criminal cases. At the beginning of the procedure the exterior body is examined and then the internal organs are removed and studied. Some pathologists argue that more autopsies are performed than necessary. However, recent studies show that autopsies can detect major findings about a person's condition that were not suspected when the person was alive. And the growing awareness of the influence of genetic factors in disease has also emphasized the importance of autopsies.
Despite the usefulness of autopsies, fewer autopsies have been performed in the United States during the past 10-20 years. A possible reason for this decline is concern about malpractice suits on the part of the treating physician. Other possible reasons are that hospitals are performing fewer autopsies because of the expense or because modern technology, such as CT scans and magnetic resonance imaging, can often provide sufficient diagnostic information. Nonetheless, federal regulators and pathology groups have begun to establish new guidelines designed to increase the number and quality of autopsies being performed.
Many experts are concerned that if the number of autopsies increases, hospitals may be forced to charge families a fee for the procedure as autopies are not normally covered by insurance companies or Medicare. Yet, according to several pathologists, the benefit of the procedure for families and doctors does justify the cost. In medical autopsies, physicians remain cautious to examine only as much of the body as permitted according to the wishes of the family. It is important to note that autopsies can also provide peace of mind for the bereaved family in certain situations.

Preparation

If a medical autopsy is being performed, written permission is secured from the family of the deceased??

Aftercare

Once the autopsy has been completed, the body is prepared for final arrangements according to the family's wishes??

Risks

There are some risks of disease transmission from the deceased. In fact, some physicans may refuse to do autopsies on specific patients because of a fear of contracting diseases such as AIDS, hepatitis, or Creutzfeld-Jakob disease.

Normal results

In most situations the cause of death is determined from the procedure of an autopsy without any transmission of disease.

Abnormal results

Abnormal results would include inconclusive results from the autopsy and transmission of infectious disease during the autopsy.

Resources

Organizations

American Medical Association. 515 N. State St., Chicago, IL 60612. (312) 464-5000. http://www.amaassn.org.

autopsy

 [aw´top-se]
examination of a body after death to determine the cause of death; it may be ordered by a coroner or medical examiner when the cause of death is unknown or the death has taken place under suspicious circumstances. Autopsies are also valuable sources of medical knowledge. Unless it is demanded by public authorities, an autopsy cannot be performed without permission of the next of kin of the deceased. Called also postmortem examination and necropsy.

au·top·sy

(aw'top-sē), Avoid the mispronunciation autop'sy.
1. An examination of the organs of a dead body to determine the cause of death or to study the pathologic changes present. Synonym(s): necropsy
2. In the terminology of the ancient Greek school of empirics, the intentional reproduction of an effect, event, or circumstance that occurred in the course of a disease, and observation of its influence in ameliorating or aggravating the patient's symptoms.
[G. autopsia, seeing with one's own eyes]

autopsy

/au·top·sy/ (aw´top-se) postmortem examination of a body to determine the cause of death or the nature of pathological changes; necropsy.

autopsy

(ô′tŏp′sē, ô′təp-)
n. pl. autop·sies
Examination of a cadaver to determine or confirm the cause of death. Also called necropsy, postmortem, postmortem examination.
tr.v. autop·sied, autop·sying, autop·sies
To subject to an autopsy.

au·top′sic, au·top′si·cal adj.
au′top′sist n.

autopsy

[ô′topsē]
Etymology: Gk, autos + opsis, view
a postmortem examination performed to confirm or determine the cause of death. Also called necropsy [nek′ropsē] , thanatopsy [than′ətop′sē] . autopsic, autopsical, adj., autopsist, n.
enlarge picture
Autopsy

autopsy

A postmortem examination of a body, which helps determine cause of death and identify any diseases that had not been detected while the patient was alive, or which confirms the presence of conditions diagnosed before the patient died.

Autopsy types 
• Biopsy only—A minimalist postmortem examination in which the prosector examines the organs, but only samples small fragments (biopsies) for histologic examination. 
• Chest only—An autopsy in which only the lungs and heart are examined; findings in a chest only autopsy are used to ID an occluding thrombus in the coronary arteries, massive patientE, or evaluate a person for compensation under the Black Lung Compensation act of 1969.
• Complete—An autopsy in which the thoracic, abdominal and cranial cavities are examined. 
• Head only—An autopsy in which the pathology of interest is presumed to reside entirely in the cranial cavity. 
• No head—An autopsy examining the chest and abdominal cavity without cranial cavity.

Infections (potentially fatal) that may pass to prosectors
Blastomycosis, coccidioidomycosis, diphtheria, erysipeloid, HBV (30% of seroconversion with infected blood exposure), HCV (up to 10% risk), HIV (0.3% risk), lymphocytic choriomeningitis, rabies, streptococci, TB (exposures as brief as 10 minutes have resulted in transmission; 10% of Finnish pathologists in active PM practice have occupational TB; autopsy-transmitted outbreaks of TB have occurred in NY, LA, Chicago and Arkansas), tularaemia, viral haemorrhagic fevers (Marburg, Ebola, Lassa), yellow fever. Two cases of possible transmission of Creutzfeldt-Jakob disease to histology technicians (not autopsy prosectors) have been reported.

autopsy

Postmortem examination, necropsy Pathology A post-mortem examination of a body, which helps determine cause of death and identify any diseases that had not been detected while the Pt was alive, or confirms the presence of conditions that had been diagnosed before the Pt died. See Forensic autopsy, Hospital autopsy, Organ-limited autopsy. Cf Psychologic autopsy.
Autopsy types
Biopsy only
A minimalist post-mortem in which the prosector examines the organs, but only samples small fragments–'biopsies' for histologic examination
Chest only
An autopsy in which only the lungs and heart are examined; findings in a 'chest only' autopsy is to ID an occluding thrombus in the coronary arteries, massive PTE, or evaluate a person for compensation under the Black Lung Compensation act of 1969
Complete
An autopsy in which the thoracic, abdominal, and cranial cavities are examined
Head only
An autopsy in which the pathology of interest is presumed to reside entirely in the cranial cavity
No head
An autopsy examining the chest and abdominal cavity without cranial cavity
.

au·top·sy

(aw'top-sē)
An examination of a corpse and the organs of a dead body to determine the cause of death or to study the pathologic changes present. (Colloquially called postmortem or post.)
Synonym(s): necropsy.
[G. autopsia, seeing with one's own eyes]

autopsy

A postmortem pathological examination done to determine the cause of death or past medical history or to assist in medical research. The term derives from two Greek roots meaning ‘seeing for oneself’.

autopsy,

n a surgical examination of a corpse performed to ascertain the cause of death.

au·top·sy

(aw'top-sē) Avoid the mispronunciation autop'sy.
Examination of the organs of a cadaver to determine the cause of death or to study the pathologic changes present.
[G. autopsia, seeing with one's own eyes]

autopsy,

n a postmortem examination performed to confirm or determine the cause of death.

autopsy

examination of a body after death to determine the actual cause of death; called also postmortem examination and necropsy. Autopsies are also valuable sources of medical knowledge.

autopsy data
data from autopsies used to illustrate the natural history of diseases and changes in their frequency are often flawed by the non-random way in which cases are selected for autopsy.
autopsy record
includes data identifying the corpse including name, address of owner, species of subject, age, sex, breed, use (as occupation in man), identifying marks, plus observations on the gross postmortem examination, the histopathological or other examinations conducted and finally an opinion about the cause of death. Useful additional documents are permission from the owner to conduct the autopsy and details of any insurance or legal interest in the examination.
References in periodicals archive ?
The membership was asked to estimate the professional work involved in adult and neonatal autopsies at their institutions, to be expressed as a multiple of the 88309 surgical pathology CPT code (Table 1).
The highest percentages of autopsies were performed on children whose deaths were unexplained (44.
Anatomical pathology autopsies provide an opportunity to fully investigate the nature and extent of disease, associated complications and co-morbid conditions, and as such the autopsy is an excellent tool to inform clinicians and to arrive at a clinico-pathological correlation.
The experts conclude that the "deficiencies, inadequacies and incongruence in the reports of the two autopsies performed-clearly make it impossible to reach any firm conclusions about the circumstances surrounding his death and the cause of it.
Despite the greater burden of proof in proving that the plaintiff suffers from mesothelioma, autopsies are not required to prove diagnosis," said Bergman.
At the height of the problem in July, the highest number of bodies requiring examinations or autopsies in one day rose to 142.
Medical information obtained from autopsies is rarely used to provide mortality statistics, although it could be useful when corroborated with clinical data; autopsy results are not available until after the death certificate is completed and filed.
Prior to the autopsy program, only 9% of these babies received autopsies, most of which were medical-examiner cases.
Of the terminations, autopsies were conducted in 132 cases in which the anomalies were identified by ultrasound with no evidence for abnormal karyotype (BMJ [online], 2003; http://bmj.
Von Hagens and Kenwright, are confident they can find a loophole in the law which technically bans autopsies in public.
Medical staff at two universities on Friday completed their autopsies of two bodies recently found near an unidentified vessel that sank in the East China Sea last year after a shoot-out with Japanese patrol boats, the Japan Coast Guard said.
Prof Wright, who is also the Dean of St Barts Hospital in London and a member of the Council for the Heads of Medical Schools, said: "At Dundee they have only had 26 adult autopsies all year.