Terence Azeke Akhator, Schädler Julia, Ondruschka Benjamin, Steurer Stefan, Möbius Dustin, Fitzek Antonia
Department of Anatomic Pathology, Irrua Specialist Teaching Hospital, KM 87 Benin Auchi Rd, Irrua 310115, Nigeria.
Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, D-22529 Hamburg, Germany.
Diagnostics (Basel). 2023 Aug 10;13(16):2643. doi: 10.3390/diagnostics13162643.
In the past years the number of hospital autopsies have declined steadily, becoming almost excluded from medical training. Medicolegal (forensic) autopsies account for almost all autopsies, whereas hospital autopsies are becoming increasingly rare. Minimally invasive tissue sampling (MITS) using post mortem ultrasound offers the opportunity to increase the number of post mortem examinations in a clinical and even forensic context. MITS is a needle-based post mortem procedure that uses (radiological) imaging techniques to examine major organs of the body, acquire tissue samples and aspirate fluid from the body cavities or hollow organs. In this study, MITS was used to determine the presence of other co-existing diseases in a deceased infected 97-year-old woman with severe acute respiratory syndrome coronavirus 2. The examination of her body was carried out using ultrasound as an imaging tool and to gather ultrasound-guided biopsies as conventional autopsy was rejected by the next of kin. Ultrasound and histology identified an intravesical mass leading to an obstruction of the urinary outlet resulting in bilateral hydronephrosis and purulent pyelonephritis, which was unknown during her lifetime. Histopathological examination revealed the tumor mass to be a squamous cell carcinoma. This study has shown that MITS can be used to determine the cause of death and the presence of concomitant diseases in the infectious deceased.
在过去几年中，医院尸检的数量稳步下降，几乎已被排除在医学培训之外。法医尸检几乎占了所有尸检，而医院尸检则越来越少见。使用死后超声的微创组织采样（MITS）为在临床甚至法医背景下增加死后检查的数量提供了机会。MITS是一种基于针的死后程序，它使用（放射）成像技术检查身体的主要器官，获取组织样本并从体腔或中空器官中抽吸液体。在本研究中，MITS被用于确定一名感染了严重急性呼吸综合征冠状病毒2的97岁已故女性是否存在其他并存疾病。由于其近亲拒绝进行传统尸检，因此使用超声作为成像工具对她的尸体进行检查，并采集超声引导下的活检样本。超声和组织学检查发现膀胱内有一个肿块，导致尿道口梗阻，进而引起双侧肾积水和脓性肾盂肾炎，而这些情况在她生前并不为人所知。组织病理学检查显示肿瘤肿块为鳞状细胞癌。这项研究表明，MITS可用于确定感染死者的死因和并存疾病的情况。
