15283-B-Blokker

9 General introduction 1 AUTOPSY Autopsy is also called dissection, necropsy, obduction or post-mortem examination. The word “autopsy” literally means “to see with one's own eyes”, which is derived from the ancient Greek ӚՕӭӨӱՆ ߂ ԏ ( autopsia ). 1 If physicians want to see for themselves what illnesses the deceased have suffered from, they perform this procedure that enables them to examine the corpse of the deceased both externally and internally. In the Netherlands, consent from next-of-kin is required to perform a clinical autopsy. AUTOPSY TECHNIQUE After an external examination of the deceased’s body, a Y-shaped incision is made from the top of each shoulder to the centre of the chest, meeting at the sternum (breastbone) and running down to the pubic bone (figure 1). 2 The anatomic relationships between organs and connected and surrounding structures (e.g. vessels, peritoneum) are examined in situ. Then, the organs are removed either one by one or ‘en bloc’ per body cavity, and further examined outside the body. After gross examination, small tissue samples from the main organs and pathologic processes are obtained for examination under the microscope, and, in some cases, for microbiological examination, toxicology or, if included in the consent by next-of-kin, for teaching and/or biomedical research. To remove the brain an incision over the back of the head is made from ear to ear, and the scalp is folded forward, allowing removal of the skull (neurocranium) and the entire brain. For proper examination the brain has to be fixed in formalin for several weeks, which makes it impossible to put the brain back into the body after completion of the autopsy. In contrast, all organs of the torso are returned to the body cavities, unless otherwise agreed by the next-of-kin. After autopsy, the body is closed by firmly sewing the skin back together, and when (ritually) cleansed it is suitable for laying out. Figure 1