Question

A 67 year old man dies after a routine operation for hernia repair. He was an ex-coalminer. He post-operatively developed pneumonia. Despite intensive treatment and eventually artificial ventilation, he died with major lung problems.

An autopsy was requested and the family was keen to know the results of the procedure.

The pathologist discussed the case with the intensive care specialists and it was agreed that the crucial question was the presence or absence of significant lung pathology, and whether there was evidence of recent or pre-existing industrial lung disease.

The pathologist said it would be best to remove the complete lungs intact and perfuse them with fixative before examination, as this would be the best way of ensuring no significant pathology was missed. He also wanted the examination of the lungs to be done by a different specialist. She worked in another hospital. He estimated that this would take up to three weeks.

4a) How should this proceed?

4b) Do the lungs really have to be retained? Explain your answer

4c) If the lungs are retained how would you subsequently dispose of them?

Answer 1

^{a) This should be proceeded by the pathologist said it would be best to remove the complete lungs intact and perfuse them with fixative before an examination, as this would be the best way of ensuring no significant pathology was missed. He also wanted the examination of the lungs to be done by a different specialist. The pathologist discussed the case with the intensive care specialists and it was agreed that the crucial question was the presence or absence of significant lung pathology and whether there was evidence of recent or pre-existing industrial lung disease.}

^{b) No, the lungs really have not to be retained because damage to the lungs makes exhalation difficult hence the air is retained in the lungs. Longstanding inflammation of the bronchioles causes chronic bronchitis. Cystic Fibrosis is a genetic condition. In CF, the mucus from the lungs is not cleared out from the bronchi so that t would be best to remove the complete lungs intact and perfuse them with fixative before examination, as this would be the best way of ensuring no significant pathology was missed}

^{c) If the lungs are damage to the lungs makes exhalation difficult hence the air is retained in the lungs. Longstanding inflammation of the bronchioles causes chronic bronchitis. Cystic Fibrosis is a genetic condition. In CF, the mucus from the lungs is not cleared out from the bronchi and Respiratory failure also can occur if your lungs can't properly remove carbon dioxide from your blood. Too much carbon dioxide in your blood can harm your body's organs. Both of these problems are low oxygen level and a high carbon dioxide level in the blood—can occur at the same time.}