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Practice of percutaneous needle autopsy; a descriptive study reporting experiences from Uganda
Janneke A Cox1, Robert L Lukande2, Sam Kalungi3
1Department of Clinical Sciences, Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerpen, Belgium ; Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda.
BMC Clinical Pathology
|December 16, 2014
Summary
Needle autopsy, a minimally invasive technique, successfully obtains sufficient tissue for pathological review. Ultrasound guidance improves success rates for certain organs, and operator experience reduces failure rates in post-mortem examinations.
Area of Science:
- Medical diagnostics
- Pathology
- Minimally invasive procedures
Background:
- Complete autopsies face numerous limitations.
- Percutaneous needle autopsy offers a viable alternative.
- This study focuses on HIV-infected adults in Uganda.
Purpose of the Study:
- To detail methods for blind and ultrasound-guided needle autopsies.
- To assess tissue yield for pathological examination.
- To evaluate the learning curve and failure rates over time.
Main Methods:
- Written informed consent obtained from next of kin.
- Procedures included blind and ultrasound-guided needle biopsies of major organs.
- Pathological review assessed tissue presence and quality; success rates and duration were recorded.
Main Results:
- 96 blind and 95 ultrasound-guided needle autopsies were performed.
- True success rates ranged from 56-99% (blind) and 72-100% (ultrasound-guided).
- Ultrasound guidance significantly improved success for heart and left kidney; a learning curve demonstrated decreasing failure rates with experience.
Conclusions:
- Needle autopsy is effective in obtaining adequate tissue for pathological review.
- Operator experience significantly reduces failure rates.
- Ultrasound guidance benefits are context-dependent; needle autopsy warrants further evaluation for determining cause of death.