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The internal examination and the samples to take

  • Procedure

The internal examination opens the body cavities in a set order, examines each organ and takes the samples that laboratory tests will need.

Updated

What it is

The internal examination confirms and extends what the external examination found: it follows each injury inside the body and looks for natural disease. Before the organs are removed, fluid samples are taken (peripheral blood, urine, vitreous humour, bile) and the cavities are checked for air, blood or other fluid. The examination is systematic, by regions or by organ systems: chest, abdomen, pelvis, head and brain, neck and spine; some examiners start with the head, and the neck is dissected last, once the blood has drained. Each organ is weighed and described, and small samples of all major organs are kept for histology. Toxicology, microbiology, DNA and entomology samples are chosen according to the case and agreed with the laboratory. How to choose and keep toxicology samples is covered in detail on its own page.

What to document

  • The order followed and any deviation from the usual technique, with the reason.
  • Weight, size and description of each organ, and all natural disease found.
  • The track of each injury: organs crossed, direction and depth.
  • Volume and nature of fluid or blood in each cavity.
  • Each sample: type, exact site, container, preservative, time taken and laboratory it went to.
  • Organs or tissues retained (for example the brain) and what the family was told.

How it is done

  1. Before opening, take peripheral blood, vitreous humour and, once the abdomen is open, urine and bile, labelling each site.
  2. Open the chest after checking for pneumothorax; inspect pleural spaces and pericardium and measure any fluid or blood.
  3. Trace each injury through the tissues before removing the organs involved; photograph internal injuries.
  4. Examine heart, coronary arteries, lungs and airways; note blood or foreign material in the trachea and bronchi.
  5. Examine abdominal and pelvic organs; open the stomach in a clean dish, describe and keep its contents.
  6. Examine scalp, skull, membranes and brain; record and keep any haematoma; consider fixing the brain for neuropathology.
  7. Dissect the neck last, layer by layer, looking for bleeding and fractures of the hyoid bone and larynx.
  8. Examine the spine and, if injury is suspected, the spinal cord; dissect back and limbs if deep bruising is suspected.
  9. Take histology samples of all major organs; list, label and hand over all samples under chain of custody.

Next step: what to do and document

  • Agree with the laboratory, before starting, which samples, containers and preservatives the case needs.
  • Always label where blood came from (femoral, heart, cavity): the toxicologist interprets the result by site.
  • Keep histology blocks and slides; they allow a second opinion years later.
  • If an organ is retained, record it in the report and inform the family, according to local rules.
  • Notify the health authority of findings of public-health importance, as Decreto 786 de 1990 requires (art. 32); a viscerotomy never replaces the autopsy (art. 5).
  • Official text checked on 2026-11-13 at funcionpublica.gov.co.

Common mistakes

  • Taking blood from the heart or a body cavity and not saying so.
  • Dissecting the neck first, while the vessels are full, and creating bruises that are not real.
  • Removing organs before tracing the wound track.
  • Taking no histology in an autopsy that looks 'obvious'.
  • Putting toxicology samples in formalin, which spoils most analyses.

Test yourself

Think of the answer, then tap the question to see it.

Which blood sample is preferred for postmortem toxicology, and why?

Peripheral blood from the femoral vein, taken before the autopsy starts, because heart and cavity blood are altered by postmortem redistribution and contamination.

Why is the neck dissected at the end of the internal examination?

After removing the brain and chest organs the neck vessels drain, so dissection does not create artefactual bleeding that could mimic strangulation.

What tissue is used for DNA in a skeletonised body?

Bone, usually the shaft of a long bone such as the femur, or teeth; in fresh bodies spleen, muscle or other soft tissue are used.

What should be checked before the chest is opened?

Whether there is a pneumothorax, because opening the chest lets the air escape and the finding is lost.

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Connections

← All of forensic medicine

Educational content on forensic and legal medicine; not legal advice and no substitute for the technical guides of Colombia's National Institute of Legal Medicine and Forensic Sciences. Laws change: each page links the official text and says when it was last checked. For a real case, follow the guide in force and ask the competent authority.

Sources: The Minnesota Protocol on the Investigation of Potentially Unlawful Death (2016) (Office of the United Nations High Commissioner for Human Rights, 2017); Decreto 786 de 1990: autopsias clínicas y médico-legales y viscerotomías (compilado en el Decreto 780 de 2016) (Función Pública, Gestor Normativo, 1990).

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