PRESERVATION OF
VICCERA
NEGATIVE AUTOPSY
OBSCURE AUTOPSY
PRESERVATION OF VICCERA
WHEN SHOULD THE VICCERA BE
PRESERVED?
If death is suspected to be due to poisoning either by
police or doctor
Deceased was intoxicated or used to drugs
Cause of death not found after autopsy
In cases where an unusual smell,colour,
unidentifiable material is detected in stomach
contents
Anaphylactic death
Death due to burns
Advanced decomposition
Accidental death involving driver of a vehicle or
machine operator.
PRESERVED VICCERA IN SUSPECTED
POISONING
STOMACH and its contents. If stomach is
empty the wall should be preserved
The upper part of SMALL INTESTINE(about
30cms in length) and its contents
LIVER 200 to 300gm
KIDNEY-Half of each.as one kidney may be
dysfunctional
BLOOD-30 ml.Minimun 10ml
URINE-30ml
IMPORTANT POINTS
Levels of drugs in the muscle more accurately
reflect blood levels than the liver or kidney
Poison found in the urine, unless added with
evil intention is a proof of absorption and
excretion
The stomach contents are of primary value
for estimating the quantity in acute overdose
and qualitatively in identifying substances
which have been recently ingested.
CONTAINERS
The glass bottle used should have- one liter capacity, clean ,
wide mouthed, white and fitted with glass stoppers
Rubber inserts should not be used under caps, because it
can extract from the contents certain poisons,such as
chloroform and phenols
Glass container should be cleaned with sulfuric
acid,chromate solution,rinsed with distilled water & dried
Poltethylene bags
Nylon bags
Blood should be collected in screw capped bottle of about
30ml
PRESERVATIVES
SATURATED SODIUM CHLORIDE
except-poisoning from corrosive acids,alkalis,corrosive
sublimate,and aconite
RECTIFIED SPIRIT
except in cases of suspected poisoning by-
1. alcohol,kerosene
2. Chloroform,ether
3. Choral hydrate
4. Formic acid
5. Formaldehyde,acetic acid
6. phenol
7. Phosphorus
8. Paraldehyde are soluble in alcohol and the phosphorescence of
phosphorus is diminised by alcohol
Ten mg/ml of SODIUM or POTASSIUM
FLOURIDE and 3mg POTASSIUM OXALATE
should be used for preserving blood
FLOURIDE should be added to urine, csf,
vitreous humour if alcohol estimaton is required
and also to samples for analysis of
cocaine,cyanide, and CO
One ml of concentrated hydrocholric acid or
100mg of thymol or 100mg of sodium
flouride can be used for 10ml urine as a
preservative. Toulene is better
INSTRUCTIONS FOR PRESERVATION
OF VISCERA
1. The stomach and its contents and the small intestine and its
contents are preserved in one bottle and the liver and kidney in
another bottle. The blood and urine are preserved seperately
2. The stomach and intestines are opened before they are
preserved. The liver and kidney are cut into small pieces of 0.5 to
1cm thickness or they can be minced in a grinder or mixer
3. The quantity of preservative should br equal tp viscera in bulk
4. Only 2/3rd of the capacity of bottle shpuld be filled with viscera
and preservative to avoid bursting of bottle if gas of
decomposition are formed
5. The stopper of bottle should be well fitted,covered with a piece
of cloth and tied by tape or string and the ends sealed
6. The bottle should be labelled which should
contain the name of the victim,autopsy number,
the organs it contains and the date and place of
autopsy
7. A sample of preservative used i.e ten ml of
rectified spirit or 25g of sodium chloride is
seperately kept in a bottle and sent to analysis
to exclude the possibilty of any poison being
present as a contaminant
8. The sealed bottles containing the viscera and
preservative are put into a box which is locked
and the lock is sealed
9. A copy of the inquest report,postmortem of
report and the authorisation from the
Magistrate are sent to the Forensic Science
Laboratory along with the viscera
10. The key of the box and a sample seal on a piece
of paper are kept in an envelope, which is sealed
and sent with viscera box
11. The viscera box is handed over to the police
constable after taking a reciept, who delivers it
personally in the office of the Forensic Science
Laboratory after obtaining the reciept for the
same.
PRESERVATION OF ADDITONAL
VISCERA
1. Brain
2. Spinal cord
3. Heart
4. Lung
5. Vitreous humour
6. Bile
7. Skin
8. Bone
9. Hair
10. Nails
11. Uterus
12. Muscles
NEGATIVE AUTOPSY
When gross and microscopic examination,
toxicological analyses and laboratory
investigations fail to reveal a cause of death,
the autopsy is considered to be negative
2-5% of all autopsies are negative
CAUSES OF NEGATIVE AUTOPSY
1) INADEQUATE HISTORY: Deaths from vagal
inhibition, status epilepticus, hypersensitivity
reaction, laryngeal spasm in drowning, etc may
not show any anatomical findings
2) INADEQUATE EXTERNAL EXAMINATION:The
presence of fresh and old needle marks may be
missed on cursory examination in a drug addict.
Death from snake bites and insect bites cannot
be explained unless the bite marks are
identified.
3) INADEQUATE INTERNAL EXAMINATION:
Air embolism and pneumothorax are often
missed
4) INSUFFICIENT LABORATORY
EXAMINATIONS
5) LACK OF TOXICOLOGY ANALYSIS
6) LACK OF TRAINING OF DOCTOR
OBSCURE AUTOPSY
Obscure autopsies are those which do not show
a definite cause of death, in which there are
minimal, indefinite or obscure findings, or even
no positive findings at all
Though the pathologist cannot establish the
cause of death he can excluded many conditions
which have been incorrectly attributed to have
caused death
Frequently these deaths are due to obscure
natural causes but they may be due to certain
types of injury or complications of injury or due
to poisoning
OBSCURE CAUSES
I. NATURAL DISEASES-
a. With obscure or few macroscopic findings
b. Death precipitated by emotion, work stress
c. With functional failure such as epilepsy,
paroxysmal fibrillation
II. BIOCHEMICAL DISTURBANCES:
a. Uraemia, diabetes, potrassium deficiency
b. Respiratory pigment disorders such as anaemic
anoxia,porphyria
III. ENDOCRINE DYSFUNCTON: Adrenal insufficiecy
and Thyrotoxicosis or myxoedema
IV. CONCEALED TRAUMA:
a. Cerebral concussion
b. Self reduced neck injury
c. Blunt injury to heart
d. Reflex vagal inhibition
V. POISONING:
a. Delayed suboxic or narcotic poisoning
b. Anaesthetic overdosage
c. Neurotoxic or cytotoxic poisons
d. Plant poisoning
VI. Miscellaneous:
a. Allergy
b. Drug idiosyncrasy
THINGS TO DO IN CASE OF OBSCURE
AUTPOSY
Interview with the persons who observed the
deceased before he died to know the signs and
symptoms shown by deceased before death
Laboratory investigations may be
bacteriological, histological, biochemical and
toxicological
In absence of any positive findings a careful
assessment of possible functional cause of death
must be made
Negative morbid anatomical and chemical
examination is important to exclude injuries or
poisons
