Histopathological investigation in forensic autopsies

Forensic autopsies are primarily conducted to determine the cause of death and to opine if the cause of death is in accordance with the postulated manner of death. These autopsies require photography, collection of evidentiary material and identification procedures, along with chemical analysis, histopathological evaluation, and other ancillary autopsy investigations. In cases of sudden unexpected deaths wherein even though the death may have occurred from an identifiable cause, the gross autopsy findings may be obscure or non-specific thus necessitating histopathological evaluation. Histopathological evaluation is however, not very commonly done in developing countries like India and its significance needs to be studied and emphasized in such countries. The present study was conducted in Kasturba Medical College, Mangalore, a medical institute affiliated to Manipal University in South India to highlight the importance of histopathological evaluation in medicolegal autopsies. Two hundred forensic autopsy cases were evaluated for histopathology in the associated Department of Pathology between January 2006 and September 2007. The autopsies were conducted by the Department of Forensic Medicine and the internal organs were subjected to histopathological evaluation in the Department of Pathology. Coronary atherosclerotic diseases, pneumonia and tuberculosis were the most frequent diagnoses observed in the autopsied cases. In the present case series, we have reviewed six of the unusual cases diagnosed solely by histopathological examination of the internal organs after autopsy during the aforementioned study period. The cases reviewed included a case of choriocarcinoma clinically diagnosed as septic abortion, acute leukemia manifesting as cerebral haemorrhage due to thrombocytopenia, tuberculous myocarditis presenting as sudden cardiac death, biliary cirrhosis in a chronic alcoholic, acute haemorrhagic pancreatitis as a cause of sudden death, and a case of sudden unexpected death due to malaria. The present research highlights on the decisive role of histopathological examination and the increasing trend of its usefulness in medicolegal work in recent times in developing countries like India.