7/28/2019 kidney autopsy techniques
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Examination of the Kidney
Ruthashini R Selvasingam
0902005207
The methods and detail for the investigation of the urogenital
organs depends on the gender
of the patient. There are two main techniques in examining the
kidney which are the external
and internal examination. An adult kidney measures approximately
11 6 3cm. The kidney
of an adult men weighs around 150g, which is slightly lesser
than the women. It would be
difficult to recognise chronic disease of an atrophic kidney. A
detail attention to the
anatomical area with histology of the dominant soft tissue would
help in identifying at least
some residual parenchyma. Fats surrounding the kidney should be
cleared away beforeweighing. On the internal examination, a
longitudinal, sagittal slice is done with a large-
bladed knife, via the kidney from the convex area towards the
hilum .The kidney must be
held firmly, placing it on the flat dissecting board and
anchored with a sponge using the non
cutting hand as the blade is drawn across the kidney.
Alternatively, the kidney can be held
between the arms of large pair of forceps where the hilar
surface faces down towards the
dissection table or board with the peripheral surface facing the
uppermost. The blade of the
knife should be carefully positioned on the angle of the forceps
and is moved downwards
towards the hilum and dissecting board. Parenchyma would be
easily demonstrated via this
technique. This technique would allow assessment of the
boundaries of cortical and
medullary areas. As the slice is extended towards the pelvis,
the hilar vessels can then be
inspected. Any mass or material within the kidney and pelvis can
be easily recognised. Stones
should be removed and their size and quality must be noted. The
kidney capsule should be
held with toothed forceps where the incision has been made
previously. The capsule should
be lifted off the outer cortex and opened back to reveal the sub
capsular surface. The
appearance of the normal sub capsular surface will be smooth.
The usual dissection of the
kidney is concluded as follow where first remove the surrounding
fat. Then slice through the
convexity in a sagital direction followed by stripping of the
capsule. Inspect the cortex and
medulla subsequently. If required, blocks for histology can be
taken. Special techniques can
be used in examining kidneys containing tumours. Renal tumours
can be visualized with the
techniques described earlier unless the mass is extremely large
and particularly if it invades
perinephric tissue. The renal vein is inspected to identify
vascular invasion which is a
common feature of these tumours. It is suggested that renal vein
should be assessed
