An approach to dissecting the congenitally malformed heart in the forensic autopsy - The value of sequential segmental analysis
An approach to dissecting the congenitally malformed heart in the forensic autopsy - The value of sequential segmental analysis
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DOI：
10.1097/00000433-200112000-00015
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发表时间：
2001-12-01
影响因子：
1
通讯作者：
Devine, WA
中科院分区：
文献类型：
--
作者：
Horn, KD;Devine, WA
先天性心脏病的尸检证明需要仔细保存和检查心脏、血管及其连接。保留这些连接并使用可再现和系统方法的技术是首选。Rokitansky器官块解剖方法与称为顺序节段分析的心脏检查系统相结合，提供了这样的方法。本研究是基于对心脏标本的检查，纳入弗兰克E。医学博士谢尔曼，和Cora C.医学博士莱诺克斯，匹兹堡儿童医院病理科心脏博物馆（包含约2400个标本）。对25年期间从医院和验尸官/体检医师办公室收到的咨询标本进行了检查，并对相应的报告进行了审查。在1975年至1999年检查的46个心脏标本中，29个（63%）在匹兹堡儿童医院正确解剖或完整解剖，17个（37%）因先天性心脏病而被错误解剖。在这17例病例中，11例（24%）显示了解剖错误，这并不妨碍完全诊断，3例（6.5%）的错误只能导致不完全诊断。3例（6.5%）不能诊断为先天性心脏病。讨论了解剖错误和避免解剖错误的方法。回顾病史和家族史，外部和内部检查。并且检查心脏及其连接的可重复和连续的方法使得能够记录甚至最复杂的心血管异常。
The demonstration of congenital heart disease at autopsy necessitates the careful preservation and examination of the heart, the vessels, and their connections. Techniques preserving these connections and using a reproducible and systematic approach are preferred. The Rokitansky method of organ block dissection, in combination with a system of heart examination termed sequential segmental analysis, provides such an approach. This study is based on the examination of heart specimens accessioned into the Frank E. Sherman, M.D., and Cora C. Lenox, M.D., Heart Museum (containing approximately 2400 specimens) of the Pathology Department, Children's Hospital of Pittsburgh. Specimens received in consultation during a 25-year period from hospitals and coroners'/medical examiners' offices were examined, and the corresponding reports were reviewed. Of 46 total heart specimens examined (1975-1999), 29 (63%) were dissected properly or left intact for dissection at Children's Hospital of Pittsburgh, and 17 (37%) were incorrectly dissected for the demonstration of congenital heart disease. Of these 17 cases, 11 (24%) displayed dissection errors, which did not hinder a complete diagnosis, 3 cases (6.5%) had errors that enabled only an incomplete diagnosis. and in 3 cases (6.5%), no diagnosis of congenital heart disease could be made. Dissection mistakes and means of avoiding them are discussed. Review of medical and family history, external and internal examination. and a reproducible and sequential method of examining the heart and its connections enables documentation of even the most complex cardiovascular anomalies.