An autopsy, also known as a post-mortem examination, is a systematic medical procedure performed on a deceased person to determine the cause and manner of death. This examination is conducted by a pathologist, a physician specializing in the study of disease and body tissues. The primary objective is to gain a comprehensive understanding of the individual’s final illness or injuries and to collect objective data for legal, medical, or academic purposes. The process begins with a detailed assessment of the body’s exterior before moving to the internal examination.
Initial Preparation and External Review
The procedure starts with the body being formally received and the identity verified against accompanying documentation. Before any surgical alteration, the entire body undergoes a thorough external examination and documentation phase. This initial assessment includes a detailed photographic record of the body and any clothing or personal effects, which are logged and removed.
The body is weighed and measured, and the pathologist notes physical characteristics like scars, tattoos, or distinguishing marks. A careful inspection is performed across the skin surface to identify any injuries, abrasions, or signs of medical intervention. Trace evidence, such as fibers or residue, may be collected, and ultraviolet light may be used to locate evidence not visible to the naked eye. The external review also involves assessing post-mortem changes like lividity (pooling of blood) and rigor mortis (stiffening of muscles), which help estimate the time and position of death.
The Internal Examination Procedure
Once the external review is complete, the internal examination begins by gaining access to the body cavities. The most common method involves a large incision made with a scalpel, typically in a Y- or modified I-shape, chosen to be discreetly concealed after the procedure. The Y-incision begins high on the chest, starting behind each shoulder and meeting at the sternum, then extending straight down to the pubic bone. This incision pattern allows for optimal visualization of the neck and chest structures.
The pathologist then carefully reflects the skin and muscle layers from the chest and abdomen to expose the rib cage and internal organs. To access the thoracic cavity, the breastbone and front portions of the ribs are removed using specialized instruments, such as a sternotome or rib cutters. A block is often placed under the back to elevate the chest, making the cavity more accessible. At this stage, the organs are inspected in situ (in their original anatomical positions) to check for fluid accumulation, displacement, or signs of disease before removal.
Detailed Organ Analysis and Sample Collection
The next stage involves the methodical removal of the organs, a process called evisceration. Organs are removed either individually or as a single large block, connected from the tongue and esophagus down to the rectum. Each organ is weighed and measured to detect any abnormal size or weight indicative of disease.
Following removal, each organ is sliced and examined internally for pathologies like tumors, blockages, or signs of injury. The brain is examined separately after an incision is made across the scalp, allowing the scalp to be peeled back and the skull cap removed using a specialized electric oscillating saw. The brain is often placed in a preservative solution before it is sectioned and analyzed, as fixation makes the tissue firmer for slicing.
Throughout the evisceration process, small tissue samples are collected from various organs for microscopic analysis, known as histology. Fluid samples, including blood, urine, or bile, are collected for detailed laboratory testing and toxicology screening to detect the presence of drugs, alcohol, or poisons. Specific samples may also be taken using sterile techniques for microbiological cultures to identify any contributing infectious agents.
Reconstruction and Final Documentation
After the internal examination and sample collection, the body is prepared for release to the funeral home. The organs are typically placed back into the body cavity, sometimes in a plastic bag to prevent fluid leakage. The skull cap is replaced, and the scalp is sewn back together using a continuous suture concealed by the hair.
The major Y-shaped incision along the torso is closed with surgical stitching to restore the body’s integrity. Once the body is cleaned, the pathologist begins the comprehensive documentation process. A preliminary report containing the macroscopic findings is often generated within days. The final autopsy report is completed only after all specialized laboratory results, including histology and toxicology, have been returned and integrated, a process that can take several weeks.