General pathology · The pathology laboratory
The autopsy: clinical and medicolegal !
- Technique
An autopsy examines the body after death to find out what the person died of and which diseases they had.
Updated 2026-11-01
What it is
An autopsy is the complete examination of a body, outside and inside, with microscopic study of the organs and, when needed, toxicology and microbiology. A clinical autopsy clarifies the disease and cause of death of a hospital patient and needs the family's consent; a medicolegal autopsy is ordered by the authorities for violent, sudden or suspicious deaths. It remains the best way to find diagnoses that were missed in life.
Key facts
- Underlying cause of death: the disease that started the chain of events (for example, coronary atherosclerosis); it is the one statistics count.
- Mechanism of death: the final physiological derangement (for example, arrhythmia); it does not replace the cause.
- Manner of death (medicolegal): natural, accident, suicide, homicide or undetermined.
- Postmortem changes: livor mortis (blood settling by gravity), rigor mortis and algor mortis (cooling).
- Postmortem autolysis destroys cells without an inflammatory reaction; necrosis in life has one.
- Minimally invasive autopsy: needle sampling of key organs; useful where a full autopsy is not possible.
Step by step
- The clinical record and the circumstances of death are reviewed.
- External examination: identification, injuries, signs of medical intervention and postmortem changes.
- Internal examination: evisceration and organ-by-organ study, with weights and description.
- Sampling: histology, cultures, toxicology and, if needed, genetic studies.
- Clinicopathological correlation: findings are compared with the clinical diagnoses.
- Final report with the underlying cause of death, which feeds the certificate and statistics.
Clinical versus medicolegal autopsy
| Feature | Clinical | Medicolegal |
|---|---|---|
| Who requests it | The treating doctor or the family | The legal authority |
| Consent | Required (family) | Not required |
| Cases | Natural death in hospital with diagnostic doubts | Violent, sudden unexpected, suspicious or in-custody death |
| Main question | Disease and cause of death; quality of care | Cause and manner of death; evidence for the courts |
| Who performs it | Pathologist | Forensic doctor (in Colombia, the national forensic institute) |
Clinical notes
- Sudden infant death syndrome is a diagnosis of exclusion that requires a full autopsy and review of the death scene and clinical history.
- A sudden death in a young person may reveal hypertrophic cardiomyopathy or another inherited disease; the finding protects the family.
- Autopsy rates are falling in many countries, although autopsies still find major diagnoses unsuspected in life.
Test yourself
Think of the answer, then tap the question to see it.
Which type of autopsy does not need the family's consent?
The medicolegal autopsy, ordered by the authorities in violent, sudden unexpected or suspicious deaths.
How is postmortem autolysis told apart from necrosis that occurred in life?
Autolysis has no inflammatory reaction; necrosis in life draws neutrophils and other inflammatory cells.
What does a diagnosis of sudden infant death syndrome require?
A full autopsy and review of the death scene and clinical history that find no other cause.
What is the difference between the underlying cause and the mechanism of death?
The underlying cause is the disease that started the chain; the mechanism is the final derangement, such as an arrhythmia.
Related
- Sudden infant death syndrome: what is known
- Infarction: red vs white, and what decides the damage
- Patterns of necrosis: coagulative, liquefactive, caseous, fat, fibrinoid, gangrenous
- Pulmonary thromboembolism: where it comes from and what it does
- Mechanical and electrical injury: abrasion, contusion, laceration, wounds
- From specimen to report: fixation, margins and the pathology report
Related conditions
- Sudden infant death syndrome (SIDS)
- Myocardial Infarction (Heart Attack)
- Pulmonary embolism
- Aortic dissection
- Hypertrophic cardiomyopathy
- Drowning
- Sepsis and septic shock
- Tuberculosis
Elsewhere in DurgiPedia
Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given.
Sources: Pathological Methods Applied to the Investigation of Causes of Death in Developing Countries: Minimally Invasive Autopsy Approach (PLoS One (PMC), 2015); Sudden infant death syndrome: MedlinePlus Medical Encyclopedia (MedlinePlus, US National Library of Medicine, 2024); About SUID and SIDS | SUID and SIDS | CDC (Centers for Disease Control and Prevention, 2024).
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Representative model, for educational purposes only.