Korean J Leg Med.  2017 Nov;41(4):94-99. 10.7580/kjlm.2017.41.4.94.

Endoscopic Examination in Postmortem Examination

• Na JY
• Park JH

• KMID: 2397683
• DOI: http://doi.org/10.7580/kjlm.2017.41.4.94

Abstract

Autopsy is recognized as the gold standard for examining the body of the deceased. However postmortem inspection, which is a method for examining the body through non-invasive modalities, is very limited. Therefore, several methods have been studied to complement postmortem examination, and endoscopy emerged as a possible method. The authors of the present study performed endoscopic examination before autopsy, and the endoscopic findings were confirmed by subsequent autopsy. The endoscope was inserted mainly through the nostril due to the rigor mortis of the jaw joint. The pharynx, larynx, trachea, and esophagus were examined. Endoscopic examination was performed on a total of 35 cases. Endoscopy revealed froth in the airway (drowning cases), as well as the presence of thermal denaturation of structures in the airway and soot attached to the froth in the airway (fire death cases). However, relevant findings were not noted during external examination. In addition, agrochemical substances were detected in the airway (agrochemical poisoning death cases) during endoscopic examination. The study found that useful information can be obtained for investigating the death and estimating postmortem interval through endoscopic examination. It is thought that minimally invasive autopsy procedures, including endoscopy, cannot replace conventional autopsies, but can be used as adjuncts instead. In particular, minimally invasive autopsy procedures are thought to be useful for postmortem inspection. To this end, continued studies, as well as the development of equipment suited for postmortem examination, are needed.

Keyword

Endoscopy; Autopsy; Minimally invasive surgical procedures

MeSH Terms

Autopsy*
Complement System Proteins
Endoscopes
Endoscopy
Esophagus
Jaw
Joints
Larynx
Methods
Minimally Invasive Surgical Procedures
Pharynx
Poisoning
Rigor Mortis
Soot
Trachea
Complement System Proteins
Soot

Figure

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  Fig. 1 This picture shows the endoscope used in this study.

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  Fig. 2 Froth was not noted around the nostril (A); however, whitish froth was noted at the vallecula and epiglottis during endoscopic examination in the saltwater drowning case (B). (C) A small amount of froth was noted around the vocal cord and in the lumen of the trachea during autopsy of the saltwater drowning case. (D) Transparent froth was noted in the vallecula during endoscopic examination in the freshwater drowning case.

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  Fig. 3 (A) Soot was attached to the face. (B) Soot was attached and froth is noted around the vocal cord during endoscopic examination. (C) Soot was attached to the tracheal mucosa and a lot of froth is noted around the tracheal carina during endoscopic examination. (D) Soot was attached to the tracheal mucosa and a small amount of froth was noted in the tracheal lumen during autopsy.

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  Fig. 4 (A) Agrochemical substance, which flows in a single stream, was noted in the trachea during endoscopic examination in the poisoning case. (B) Similar agrochemical substance is noted in the tracheal lumen during autopsy.

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