Postmortem Aortic Dissection: An Artifact of the Embalming Process

Abstract

Aortic dissection (AD) is a serious condition that affects 3/100,000 individuals a year. Recently, a case report was published describing an embalmed patient with an aortic dissection. The purpose of this study was to examine the frequency of AD among 80 embalmed cadavers and confirm the AD with histopathologic evaluation. In seven cases of grossly identified AD, six were determined to be due to the embalming procedure and only one case of true antemortem AD was confirmed. These results suggest that aortic morphology can be altered by administration of the embalming fluid and that alterations can mimic AD, not only on gross inspection but also on postmortem imaging. Awareness of this embalming artifact may prevent misdiagnosis of an aortic dissection in an embalmed patient, a point particularly useful for autopsy pathology that may include postmortem examination of an embalmed patient.

Artifactual aortic dissection as a result of post-mortem CT angiography

“…The aforementioned case study prompted Rae et al to perform a retrospective study on eighty embalmed bodies to determine the frequency of aortic dissection with subsequent histological confirmation [6]. Seven of the eighty bodies were found to have an aortic dissection, however, only one was found to be a true antemortem aortic dissection based on the presence of an intramural hematoma on gross examination and confirmed histologically.…”

“…In five cases, the aortic dissection was located around the embalming cannula. Rae et al concluded that mechanical separation of the aortic wall occurred during the embalming process, however they could not clearly identify if this was a result of flow of the embalming solution, or embalming solution-induced hardening and subsequent splitting of the aortic wall [6].…”

“…A recent report in the literature describes several cases of artifactual aortic dissection in embalmed individuals [6]. In their paper, Rae et al postulates that the cause of such artifactual aortic dissection [6] is either the flow of the embalming solution through the aorta and its branches (i.e.…”

“…In their paper, Rae et al postulates that the cause of such artifactual aortic dissection [6] is either the flow of the embalming solution through the aorta and its branches (i.e. a mechanical effect), or embalming solution-induced hardening of the intima causing it to split from the aortic wall (i.e.…”

A New Resource for Integrated Anatomy Teaching: The Cadaver’s Lung PG, A Pathology Guide

“…However, little information is available that describes the uniqueness of the embalmed cadaveric lung. It has been shown that the embalming process causes artifacts (Rae et al 2015) and it is possible that embalming affects the gross presentation of all of the cadaveric organs.…”