Needle necropsy.

The importance of post-mortem examination is generally accepted, not only for instruction and research, but also for raising the standard of medical practice. Unfortunately, there are many obstacles. In hospital, necropsies are limited by the natural reluctance of many relatives to give the necessary permission. In nursing homes and private houses, they are seldom performed because of the additional problems of inadequate facilities and lack of time. Correspondence in the British Medical Journal expressed concern at the difficulties of obtaining necropsies on patients dying outside hospital (Loewy, 1953; Davies, 1953 Wade, 1953). It is, however, possible to obtain adequate diagnostic post-mortem specimens with a needle. Such a procedure does not dismay relatives and can be carried out quickly and without trouble with an appropriate instrument. The purpose of this communication is to discuss the technique of needle necropsy and to describe a suitable instrument which has given satisfactory results during the past five years. Necropsy Instrument The instrument is essentially that previously described for needle biopsy of the liver (Terry. 1949) but with a modified needle of larger bore. It consists of a 20 ml. syringe adapted to carry a 3 mm. (internal diameter) needle, 15 cm. long, on the barrel and a trocar on the piston (Fig. 1). The point of the needle is notched and sharpened to ensure that it cuts into the tissue. A bevelled point has been discarded, since it is blunted by hard tissue such as bone, and fails to obtain specimens from spongy tissue such as lung. The trocar has a cutting point, which projects 1 cm. beyond the needle: it is flattened along one side so that pressures within the syringe, positive or negative, are transmitted down the needle to the specimen. A spring-catch on the cap of the syringe engages with notches on the pistonrod and maintains the piston in place after suction has been applied.