OBESITY : THE POSTMORTEM ( IN A NUTSHELL )

                      OBESITY :  THE POSTMORTEM 

This was a documentary about the entire procedure of the post mortem of an obese woman who died of the HEART FAILURE ( HYPERTENSIVE HEART DISEASE ) , In this section we will first understand the basic steps and procedures of post mortem and also see the characteristic changes that emerge in the body when there is an unusual accumulation of fat inside it. 

We will also try to find out , that if that lady wouldn't have died because of HEART FAILURE what could have been the other LIFE- THREATNING diseases which probably would have caused her death in the future .

WHAT IS POST MORTEM ?

Post mortem,  also known as Autopsy is an examination of the body after the death . It's main aim is to find out the probable causes of death.        

There are various steps involved in the procedure of post mortem , we will try to look at each one of them with respect to the case of obesity and fat : 

• External examination of the body ..

In the case that we have considered , the external information about the  body was :

1. The patient had died because of heart failure ( HYPERTENSIVE HEART DISEASE)
2. The patient had minimal consumption of alcohol .
3. The patient was very obese and had a great accumulation of fat in the abdomen area compared to the rest of the body . 

( Usually, the accumulation of fat in the abdominal area is accompanied by more complications and risk to the life rather than it's accumulation in the thigh or shoulder region.)

THIS WAS FOLLOWED BY MAKING AN INCISION THROUGH THE BODY FROM THE TOP OF THE STERNAL NOTCH ( NEAR THE NECK ) TO THE END OF THE TOP OF PUBIS REGION.

There was a very thick layer of fat tissue/ adipose tissues containing fat cells / ADIPOCYTES. The texture of thus fatty layer is very buttery or greasy . It's color variates from bright yellow to pale yellow depending among various regions of the body.
 

• Removing the breast plate from the body

This procedure helps in exposing the inner vital organs of the CARDIO - RESPIRATORY block ( that includes the organs such as lungs, heart )

                                                         breast plate removal.

• Removing the cardio- respiratory block 
  

In this procedure , the entire cardio- respiratory block was removed from the connection of bundles of white fibrous tissues that connect the block to the spinal cord. This is followed by the first procedure that can indicate the cause of death , i.e. 

DISSECTION OF HEART AND LUNGS ( IN ORDER TO FIND ANY EVIDENCE OF DAMAGE RELATED TO OBESITY )

1. LUNGS 

In the case of an obese women , the lungs looked quiet healthy and didn't had any damage when looked from the outer surface.

But when the LUNGS WAS SQUIZZED OUT THEN A STRANGE THING WAS SEEN -

a red - watery fluid dripped out of these lungs - which indicated the disorder of PULMONARY EDIMA - which is seen as a heart failure fluid . So from here we get the information that the body may have died due to heart failure and we all know that the obese women died because of thus particular failure only.

                                                             

( this fluid would have caused shortness of breathe that she would have suffered every day in her life, thus our daily lifestyle also gets effected because of this but we often ignore it and finally it leads to these dangerous disorders.)

Before moving further we must know a minor difference between HEART ATTACK and HEART FAILURE :

Heart attack is a sudden process that damages the heart , it is a very rapid process that happens in a short period of time . But the heart failure is a very slow and gradual process and it happens in a very long period of time ( 4 - 5 years ) or even more in some  cases .

       2. HEART ( the most important organ in this case ) 

While starting the procedure of dissecting the heart , the first thing that was seen was an UNUSUAL AMOUNT OF FAT AROUND THE PERICARDIAL SAC ( THE PERICARDIUM PROTECTS THE HEART ) .

The second thing was - generally if someone will touch the heart , it will have a stiff or tough texture but in this particular cadaver the HEART WAS VERY BAGGY AND SOFT .

The third and the most important characteristic seen in the heart was the UNUSUAL WEIGHT OF THE HEART,  it weighted 449 grams which is very h than the usual heart.

This overweight of heart is due to heart failure caused due to high blood pressure .

( The heart basically has to pump to keep up the pressure , as a result the heart grows bigger and bigger but there comes a point when the cardiac muscles get exhausted and they can't get any bigger now and finally fail to do their work. )

INSIDE THE HEART ,

Another change that was seen inside the heart surface was the diameter of the left ventricle.

The wall of left ventricle  in a fit person is usually an inch thick .

But in this case , THE WALL OF THE LEFT VENTRICLE MUSCLES WAS AROUND 8MM THICK.

                                                   wall of left ventricle muscle.

• REMOVING THE COELIAC BLOCK 

Which is  disconnecting the organs from the white fibrous membrane that attaches the entire block to the spinal cord . This procedure is followed by the dissection of the digestive organs which mainly include stomach and liver.

          3. STOMACH

It was a health stomach and no such change was there in it.

         4. LIVER 

The first thing that was visible while the dissection of the liver was the that THE LIVER WAS EXTREMELY LARGE AND HEAVY THAN THE USUAL LIVER .

Second , the surface of the liver was PINK COLOURED due to the mixing of FATTY TISSUES 9 YELLOW) + THE LIVER CELLS ( HEPATOCYTES ) WHICH IS DARK RED IN COLOR.

The common cause of fatty liver is either an uncontrollable consumption of alcohol or obesity , but through the external examination we knew that the patient consumed minimal amount of alcohol therefore, more likely the reason of fatty liver is OBESITY only.                                                                                                                                                  pink surface of liver

It can cause damage to liver and lead to CIRRHOSIS, CANCER and LIVER FAILURE .

Thus, if the women had not died of HEART FAILURE she would have died due to LIVER FAILURE in the future .

• REMOVING  GENITO - URINARY BLOCK.

This procedure is followed by the dissection of KIDNEY.

           5. KIDNEY

The first thing that was seen during the dissection was the UNUSUAL AMOUNT OF FAT AROUND THE KIDNEY ( PERI- RENAL FAT ) 

 

                                                        fat around the kidney

Second is that, ideally the kidney surface should be smooth , but this women's cadaver had some scars on the surface, which is also associated with high blood pressure .

• RECONSTRUCTING THE BODY 

This is the final procedure in which all the organs that were removed during the post mortem in a VISCERAL BAG and then into body cavity , after that a heavy post mortem twine is used to stich the body along where the INCISION was made .

         

In this way the procedure of post mortem gets over ..

                                                         THANK YOU...