Atlas of Forensic Pathology

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ATLAS OF FORENSIC PATHOLOGY

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Figure 31.9. Dissection of the atrioventricular node. One approach is to remove the non-coronary cusp of the aortic valve with the subja cent myocardium (where the atrioventricular node is located) ( A ) and serially section this segment of tissue ( B ).

EXAMINATION OF ESOPHAGUS FOR VARICES WHEN PERFORMED When the autopsy identifies cirrhosis associated with a gastrointestinal hemorrhage, one likely source is bleeding esophageal varices. HOW PERFORMED A nick is made in the stomach close to the gastroesophageal junction. A clamp is passed through the nick to the proximal end of the esophagus (assuming that the esophagus, stomach, and pancreas are in their own separate block and not still attached to the remainder of the organs). The proximal end of the esophagus is secured (ie, pinched) in the clamp, and then the proximal esophagus is pulled through the nick in the stomach (Figure 31.11A and B). This process everts the esophagus and reveals the varices. The process potentially keeps pressure on the esophageal veins, allowing them to stand out, but also prevents their blind cutting if the esophagus into the stomach were to be opened as usual.

A B Figure 31.10. Dissection of the parathyroid glands. The superior parathyroid glands can easily be identified near the junction between the larynx and trachea posterior by reflecting the most superficial layer of fascial tissue after removal of the neck organs from the body ( A and B ). Copyright © Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 2023