Postmortem Examination and Negative Autopsy

, Hwang Juck-Joon

Original Article

Korean Journal of Legal Medicine 1989;13(2):51-55.

Department of Legal Medicine, College of Medicine, Korea University

Abstract

The forensic pathologists or medical examiners involved in the investigation of medicolegal cases can expect to come across cases of negative autopsy. One may consider that when no cause of death is found at the postmortem table the autopsy is negative. An autopsy is considered to be negative when all efforts, including gross and microscopic studies and toxicological analyses, fail to reveal a cause of death. Theoretically speaking, there must be a cause of death, but in practice it is not possible to establish the true cause of death in every case. A negative autopsy may result from one of the following factors. 1. Autopsy carried out without adequate history. 2. Lapses in external examination 3. Inadequate or improper internal examination. 4. Insufficient histological examination 5. Lack of toxicological and other investigations. 6. Pathologist's training. In the following paragraphs, several of the conditions that can be missed at autopsy or those that can create difficulty in interpretation are described. 1. Deaths from fright or shock 2. Concealed or apparently insignificant trauma. 3. Lesions of the nervous system 1) Concussion 2) Atlanto-occipital joint dislocation with spinal cord injury 3) Epilepsy 4) Chronic encephalitis 5) Fat or air embolism 6) Delirium tremens 4. Lesions in the neck 5. Lesions of cardiovascular system 1) Distal coronary artery occlusion 2) Coronary spasm 3) Pathology Of the SA and AV nodes and bundle of His 4) Asymmetrical obstructive hypertrophy of the heart 5) Myocarditis 6) Periarteritis nodosa 7) Brown atrophy of the heart 8) Sarcoidosis 6. Lesions Of the adrenal glands 7. Sickle cell disease 8. Decomposition