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Preparing for the autopsy…

• It is compulsory to analyze all the medical documents
(patient’s medical history, clinical history, clinical epicrisis,
the results of laboratory and radiological tests etc).
• After careful analysis of medical documents, the set of
actions how to perform an autopsy is prepared by
pathologist himself with a purpose to apply an adequate
methods for morphological analysis and focus for the
most important issues.

Note: always be prepared to find something unexpected!

Participation in autopsies
Clinical postmortem examination is
performed by pathologist, pathology
resident and assistants of pathology staff.

Other participants:
Doctors and residents from departments,
where diagnostic and therapeutic procedures
were applied to the deceased
Students
Representatives of healthcare institution’s
administration
Forensic medicine expert, if required or sent by
legal institutions.

Participation in autopsies
• When autopsy is performed to the
patients after surgical procedures, it is
important for the surgeons to
participate in postmortem
examination.
• Surgeon is able to present more
accurate data regarding the surgical
procedure’s details, preoperative
condition of the patient, possible
complications and causes of death.

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Participation in autopsies
• Autopsy is a biologically
hazardous procedure with a
potential to become a source
of various infections.
• When participating in autopsy
it is important to protect the
performers and the
participants of the autopsy.
• It is necessary to follow the
work safety regulations and
wear protective gear (gloves,
white coats, eye protection
etc.)

During the autopsy…

• The samples of further histological analysis are
taken from each and every organ.
• In particular cases, the samples are also taken for
microbiological, viral and biochemical tests.
• If the diagnosis from macroscopic pathological
changes found in the organs can not be established
properly, an urgent histological analysis is also
available.
• All the changes found during the autopsy are
recorded by using a photo camera.

Management of medical death certificate after

autopsy
(by the example of Lithuanian healthcare model and legal infrastructure)

Form Nr. 106/a “Medicininis mirties liudijimas” (in english

“Medical death certificate”) or form Nr. 106-2/a
“Medicininis perinatalinis mirties liudijimas” (in english
“Medical perinatal death certificate”) is filled in and signed
by the pathologist who performed the autopsy or the
resident pathologist supervised under the pathologist.

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Management of perinatal medical

death certificate
(by the example of Lithuanian healthcare model and legal infrastructure)

Form Nr.106-2/a “Medicininis perinatalinės mirties liudijimas” (in

english „Medical perinatal death certificate“):
a. The section with personal data is filled by the doctors of the
department where the newborn died or a stillborn was delivered;
b. This form Nr.106-2/a is presented to the department of pathology
with a „Medical birth certificate“ and patient‘s history form.

Note: If the autopsy is not performed to the deceased, the form Nr.
106/a „Medicininis mirties liudijimas“ (in english „Medical death
certificate“ is filled in by the doctor who was taking care of the
patient or the doctor who was at watching shift.

Management of the deceased

(by the example of Lithuanian healthcare model and legal infrastructure)

• Body of the deceased is given back

to their relatives or legal
representatives.
• Relatives or legal representatives
must present a death certificate and
identification documents.
• Transfer of deceased’s body is
usually available at working hours,
but this process can be performed at
watching shifts.
• Transfer process is recorded in the
journal.

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Form Nr. 013-1/a “Patologinio anatominio

tyrimo protokolas”
(in english “Protocol of postmortem analysis”)

A. Form is filled in by pathologist or resident pathologist

supervised by pathologist.
B. If form is filled by resident pathologist, it is signed by
resident pathologist and a supervising pathologist.
C. This form is kept in the department of pathological
anatomy for a year.
D. Then all the forms are transferred to the archive and
must be kept there for 25 years.

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Construction of pathology diagnosis

• When autopsy is finished, preliminary pathological anatomical
diagnosis is established according to the identified macroscopic
changes and the data of urgent microscopic analysis.

• Final pathological anatomic diagnosis is constructed when the

detail histological examination is performed as well as clinical
and macroscopic postmortem analysis data are evaluated all
together.

• Structure of pathology diagnosis:

a) Main disease
b) Complications
c) Other diseases

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Results of clinical postmortem examination

Recorded and kept in the archive with patient’s hospital history,
other medical documents
For complicated cases  clinical anatomical conferences are
organized, and doctors who performed diagnostic and therapeutic
procedures participate actively focusing on the issues related to
the case
This particular case is presented in a wider clinical context
discussing about the national and international experience, as well
as diagnostic and treatment guidelines

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Regulations of archive’s management

(by the example of Lithuanian healthcare system)

• Form Nr. 017-1/a “Pomirtinio

tyrimo skyrimo aktas” (“Act for
designating postmortem
examination)  25 years
• Form Nr. 013-1/a “Patologinės
anatomijos autopsijos protokolas“
(„Protocol of Pathology autopsy“)
 25 years
• Form Nr. 015/a „Mirusių asmenų
registravimo žurnalas“ (“Journal
for recording the deceased “)  5
years

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Minimally invasive or non-invasive autopsy – a new

direction towards precision and perfection of
postmortem analysis...

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