Bankl H C, Pikula B, Bankl H
Institut für Klinische Pathologie, Krankenhaus St. Pölten.
Dtsch Med Wochenschr. 2001 Mar 9;126(10):258-62. doi: 10.1055/s-2001-11738.
Legal regulations of cadaver examination and autopsy require fundamental changes. Regulations that result in up to 75% errors in the recorded cause of death on the death certificate make no sense. As an example, rare disease of bronchial malformation may cause sudden, unexpected death but is only detectable at autopsy with subsequent histological examination.
In an series of 17.204 autopsies (from 1980 to 1999) 894 cases of sudden, unexpected death were examined. In 28 cases (3.1%) only histological examination of the lungs provided the cause of natural death.
Bronchial dysplasia may be clinically silent and leads to focal panazinar emphysema and atelectasis due to chronic airflow obstruction and an "air trapping" mechanism. Subsequent pulmonary hypertension results in a cor pulmonale, which may fail suddenly and unexpectedly.
The diagnostic problems of natural death justifies the performance of an autopsy. This fact should be recognized legally. Using the example of bronchial malformation, it is shown that only an autopsy may reveal the exact cause of death.
尸体检查和尸检的法律法规需要进行根本性变革。那些导致死亡证明上记录的死因出现高达75%错误的法规毫无意义。例如，罕见的支气管畸形疾病可能导致突然、意外死亡，但只有通过尸检及后续组织学检查才能发现。
在一系列17204例尸检（1980年至1999年）中，对894例突然、意外死亡病例进行了检查。在28例（3.1%）病例中，仅肺部的组织学检查揭示了自然死亡的原因。
支气管发育异常在临床上可能没有症状，由于慢性气流阻塞和“空气潴留”机制，会导致局灶性全小叶肺气肿和肺不张。随后的肺动脉高压会导致肺源性心脏病，可能突然且意外地衰竭。
自然死亡的诊断问题证明了尸检的必要性。这一事实应在法律上得到认可。以支气管畸形为例，表明只有尸检才能揭示确切的死亡原因。
