Clinical application of natural orifice transluminal endoscopic surgery in autopsy:a case report
10.13618/j.issn.1001-5728.2024.05.010
- VernacularTitle:经自然腔道内镜手术在尸检中的临床运用初探
- Author:
Xiao CHEN
1
;
Zhiqiang WANG
;
Huaiyin SHI
;
Jing LIU
;
Zhanbo WANG
;
Qing ZHOU
;
Yonghe FU
;
Shiping XU
;
Hui SHI
Author Information
1. 中国人民解放军总医院第二医学中心消化内科,北京 100853
- Keywords:
Natural orifice transluminal endoscopic surgery NOTES;
Transesophageal NOTES;
Transgastric NOTES;
Autopsy;
Severe acute respiratory syndrome corona virus 2(SARS-CoV-2)
- From:
Chinese Journal of Forensic Medicine
2024;39(5):572-576,583
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the feasibility of minimally invasive autopsy by natural orifice transluminal endoscopic surgery.Methods Autopsy was performed on a deceased patient with COVID-19 via transesophageal,transtrachea,and transgastric natural orifice transluminal endoscopic surgery.The white light endoscopic manifestations of the corresponding organs were observed,and organ tissue specimens were obtained for routine pathological examination.Results All four pathways reached the corresponding organs successfully.Diffuse congestion and submucous bleeding were seen in the trachea,bronchus and bronchus of the pulmonary lobes.The bronchus of the left lower lobe was filled with dark red sputum;the surface of the left lung was congested obviously.Four thrombi and plaque rupture were seen on the aortic wall.The gastric mucosa was congested,eroded,and had active ulcers.The surface of heart and liver was smooth.Small lamellar panniculitis was seen in the omentum.Routine pathology showed chronic inflammation with acute inflammation of the bronchial mucosa and inflammatory exudation,and partial squamous metaplasia of the epithelium.In lung tissue,some alveolar epithelial hyperplasia,a little fibrin-like exudation,widened alveolar septa,and infiltration of acute and chronic inflammatory cells were seen.The columnar epithelial mucosa of the gastric mucosa showed chronic inflammation with acute inflammation and exudates and fungal masses.Conclusion Natural orifice transluminal endoscopic surgery is feasible for autopsy,and covid-19 virus can cause multi-system and multi-organ damage.
