Gross and Histopathological Study of Adrenal Glands from Routine Medico legal Autopsies

Abstract

Background: Autopsies are important in clinical medicine as they can identify medical errors and assist in
continuous improvement. The role of a forensic pathologist is highly significant in determining the cause of death
as an undiagnosed case can contribute to the improvement of clinical or surgical management of such type of
patients, and help prevent unexpected deaths in the future. In an era, where pathological autopsies are limited,
the medico-legal autopsy will serve as supplement to document the incidental adrenal pathologies in the study
population.
Material and Methods: The prospectivestudy was performed after getting proper approval from Institute ethical
committee. The adrenal glands were procured from medico-legal autopsies conducted from 2019 -2021, at the
mortuary of Govt. Medical College and Hospital, Aurangabad. All the necessary details were noted from the
police requisition, Inquest panchnama and clinical papers provided. All the important findings were noted down
in the predesigned case record form.
Result: A total of 128 adrenal glands were examined for gross and histopathological changes. The number of males
and females studied comprised of 38 males (59 %) and 26 females (41%). Majority of lesions were observed on
histopathology as compared to gross examination. Maximum number of the lesions were observed in the age group
between 21 to 30 years (29%). Gross adrenal lesions were noted in 62% males and 38% females. Histopathology
lesions were noted in 63% males and 37% females. The study showed more of unnatural cases than natural cases.
Majority of the lesions are seen in unnatural deaths than natural deaths except enlarged adrenals are found in
natural deaths. Majority of the adrenal histopathology lesions were found in unnatural deaths except adrenalitis,
hypertrophy and atrophy which is common in natural deaths. Majority of the lesions are found in unnatural
deaths both on gross 73% as well as histopathological 67% examination.
Conclusion: This study emphasizes the importance of Gross as well as Histopathological examination in medicolegal
autopsies. In cases of negative autopsies, this necessitates to examine the adrenal glands, histopathologically which
may give a clue about the cause of death.