The Importance of Histological Examination in Forensic Medical Practice

R. Hadjiev, Margarita Tankova, S. Philipov
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Abstract

Background: Histopathological examination plays a significant role in the precise determination of the cause of death. Death scene investigation, full medical history of the patient, thoroughly performed macroscopic exploration of the bodyand its internal organs, supported by the results from a microscopic histological examination of the tissues, determine the forensic medical autopsy standards. These, as well as the skills and the experience of the forensic medical expert, guarantee an accurate forensic medical diagnosis for the medico-legal needs. Methods: In order to sustain our preposition, we present a case from our practice. A man died during a hospital treatment for anemia and an autopsy, requested by the relatives, was performed. It was concluded that the cause of death was a hypostatic pneumonia. During the autopsy a histological material was taken but no examination was made. Months later, following a prosecutor’s order a histological examination was performed and evidence for a disseminated intravascular coagulation was found. Conclusion: This is one of many cases in which there is a difference between the macroscopic and the histological diagnosis. Histopathological examination of the internal organs for the purpose of providing a medical cause of death is essential for the forensic practice and it should be undertaken whenever there is a doubt in the macroscopic diagnosis.
组织检查在法医学实践中的重要性
背景:组织病理学检查在准确确定死亡原因方面起着重要作用。死亡现场调查,充分了解患者病史,对尸体及其内脏进行了彻底的宏观探查,并根据组织的显微组织学检查结果,确定了法医尸检标准。这些,以及法医专家的技能和经验,保证了准确的法医诊断,以满足法医的需要。方法:为了支持我们的介词,我们从实践中提出一个案例。一名男子因贫血在医院治疗期间死亡,应其亲属的要求进行了尸检。最后得出的结论是,死因是肺源性肺炎。在尸检过程中,取了组织学材料,但没有进行检查。几个月后,根据检察官的命令,进行了组织学检查,发现弥散性血管内凝血的证据。结论:这是许多病例中有差异的宏观和组织学诊断之一。对内部器官进行组织病理学检查,以提供医学上的死亡原因,这对法医实践是必不可少的,只要对宏观诊断有疑问,就应进行这种检查。
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