Role of pyloric sphincter in estimating time since death &amp; in toxicological analysis

R, Sudalaimuthu.; Manoharan, C; Biradar, Gururaj; Bakkannavar, Shankar M; Joe, Angela

doi:10.5958/2394-6776.2016.00023.0

Cited by 1 publication

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“…Pyloric sphincter rigor mortis impeded duodenal intubation in 3 cases. This phenomenon arises 2 hours postmortem and resolves by 12–14 hours in uncooled bodies [ 26 ]. It is encouraging that this obstruction was not more prevalent in this study, where most procedures commenced within 14 hours and all bodies underwent refrigeration.…”

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Postmortem Intestinal Tissue Sampling in Malnourished and Acutely Ill Children Is Feasible and Informative

Feutz

Voskuijl

Finch

et al. 2021

Clinical Infectious Diseases

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Background Intestinal disorders such as environmental enteric dysfunction (EED) are prevalent in low- and middle-income countries (LMICs) and important contributors to childhood undernutrition and mortality. Autopsies are rarely performed in LMICs but minimally invasive tissue sampling is increasingly deployed as a more feasible and acceptable procedure, although protocols have been devoid of intestinal sampling to date. We sought to determine (1) the feasibility of postmortem intestinal sampling, (2) whether autolysis precludes enteric biopsies’ utility, and (3) histopathologic features among children who died during hospitalization with acute illness or undernutrition. Methods Transabdominal needle and endoscopic forceps upper and lower intestinal sampling were conducted among children aged 1 week to 59 months who died while hospitalized in Blantyre, Malawi. Autolysis ratings were determined for each hematoxylin and eosin slide, and upper and lower intestinal scoring systems were adapted to assess histopathologic features and their severity. Results Endoscopic and transabdominal sampling procedures were attempted in 28 and 14 cases, respectively, with >90% success obtaining targeted tissue. Varying degrees of autolysis were present in all samples and precluded histopathologic scoring of 6% of 122 biopsies. Greater autolysis in duodenal samples was seen with longer postmortem interval (Beta = 0.06, 95% confidence interval, 0.02–0.11). Histopathologic features identified included duodenal Paneth and goblet cell depletion. Acute inflammation was absent but chronic inflammation was prevalent in both upper and lower enteric samples. Severe chronic rectal inflammation was identified in children as young as 5.5 weeks. Conclusions Minimally invasive postmortem intestinal sampling is feasible and identifies histopathology that can inform mortality contributors.

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Section: Discussionmentioning

confidence: 99%