jiafm, 2010-32(2) april-june. - forensic medicine

ISSN 0971-0973 J Indian Acad Forensic Med, 32(2)Original research paperHisto-Pathology Examination in Medico-legal AutopsyPros & Cons*Dr. Akhilesh Pathak, ** Dr. H.M. MangalAbstractMedico legal autopsy examination is performed by the forensic expert with a view to searching primarilyfor the cause of death. It is performed on the instructions of legal authority in circumstances relating to suspicious,sudden, obscure, unnatural, litigious or criminal deaths and the information so derived, to be applied for legalpurpose to assist the course of justice. Medico legal autopsies differ in the purpose and procedure from pathologicalautopsies but sometimes they overlap with each other at various levels. Histopathology examination is commonlyasked by autopsy surgeon to establish the cause of death when he recognizes any morbid anatomical changes intissues and suspect that it may be the reason for cessation of vital functions of deceased. During the period of threeyears from 2005-2007, a retrospective study was conducted at PDU Medical College, Rajkot to know weatherroutine histo-pathological examination is essential in medico legal autopsies or it is creating only an extra burdenover the pathologists, autopsy surgeon and law enforcing agencies in any way.Key Words: - Autopsy, Histopathology, Cause of death, MedicolegalIntroduction:An Autopsy, literally meaning self study ofa dead body, is carried out for clinical as well asmedico-legal purposes. Clinical autopsy, looselytermed as pathological autopsy, is carried out todiagnose the disease which has caused the mortalitywhen ante-mortem efforts have failed. Many a timesclinical autopsy is done despite the cause of deathhaving been established ante mortem, to study thedisease process in situ, thus enriching medicalknowledge. Medico-legal autopsy is performed withthe aim of providing answers to questions about theidentity, cause of death, time of death, circumstancesof death, etc. thus helping the law enforcing agenciesto solve the crime.Although the procedure of both theautopsies is same, they differ from each other inmany aspects. Usually the clinical autopsy isperformed by the pathologist and Medico-legalautopsy by a Forensic expert._______________________________________Corresponding Author:Dr. Akhilesh Pathak*Associate Professor,Forensic Medicine Department, Govt. MedicalCollege,Vadodara. (Gujarat)E-mail: dr.akhilesh_pathak@yahoo.co.in** Professor, Forensic Medicine Department,PDU Medical College, RajkotHowever on occasions, especially in ArmedForces Medical Services (AFMS) setup and inMalaysia, the pathologist may have to perform aMedico-legal autopsy. On the other hand an autopsystarted as Medico-legal autopsy by a forensic expertmay turn out to be a purely clinical autopsy, e.g. incases of sudden death [1].Forensic histopathology is a very importantbranch of Forensic Medicine. It deals with themicroscopic analysis of various changes atcellular/tissue level throwing light on cause of death,solving a crime mystery. It is microscopic study oftissues of the deceased. To be complete histopathologist,one has to be competent in handlingmicroscopes and histo-techniques [2].The utility of histopathological findings indeath due to electrocution and poisoning has beenreported by various authors[3,4,5] while the otherauthors[6,7] believe that histopathologicalexamination is not of much useful modality in casesof medicolegal postmortem examination. Gupta et al[6] and Jani et al [7] have reported in their studiesthat histopathology examination in postmortemexamination should be used in a manner which ismore rational and not defensive. Mollina et al [8]have reviewed brain, heart, and liver, kidney, andlung sections on 189 routine forensic cases andcompared the results to the gross anatomic findings.They have also reported almost same conclusion inher study in which microscopic examination affectedthe cause of death in only 1 case out of 189 studiedcases, while in no case the manner of death wasaffected by it.128