ABSTRACT
The anatomical pathology autopsy serves several purposes, notably as a quality management tool for evaluation of accuracy in clinical diagnosis. Despite its value, for various reasons there has been an international decline in autopsies conducted. In the modern medical era, with all its advances in technology, diagnostic techniques and interventions, there is still a high discrepancy between clinical diagnoses and postmortem findings.Objectives. To establish the discrepancies between clinical diagnoses and postmortem findings in anatomical pathology autopsies.Methods. A retrospective, descriptive study was conducted over the 4-year-period 2014 - 2017. The clinical diagnoses and postmortem findings of cases referred to the Department of Anatomical Pathology at the University of Pretoria, South Africa, were evaluated and compared using the modified Goldman criteria.Results. A total of 288 cases qualified for the study and were evaluated. The gender distribution was 155 (53.8%) male and 133 (48.2%) female, with the majority of cases in the age group 19 - 60 years (mean 36.4). The majority of the cases were referred by internal medicine, followed by paediatrics. The most common cause of death in major missed diagnoses was pulmonary conditions. Of the cases, 115 (39.3%) had a major discrepancy and 62 (21.5%) a minor discrepancy.Conclusion. This study showed that there is still a high discrepancy between clinical diagnoses and postmortem findings, similar to studies conducted globally. The current COVID-19 pandemic may be a driver for revival of the anatomical pathology autopsy, and future studies are recommended to evaluate whether the decline can be reversed
Subject(s)
Humans , Pulmonary Atelectasis , Clinical Laboratory Techniques , Pathology , Autopsy , Comparative StudyABSTRACT
La chirurgie à coeur cardiaque est un mode de traitement des pathologies cardio-vasculaires et médicales. Elle n'est plus pratiquée en République Démocratique du Congo (RDC) depuis plusieurs décennies. Nous rapportons le cas clinique d'une fillette de 12 ans admise aux Cliniques Universitaires de Kinshasa pour atélectasie totale du poumon gauche, soignée auparavant comme une tuberculose pulmonaire, et dont le bilan a révélé un faux anévrysme géant de l'aorte descendante. Devant cette urgence, la seule thérapie possible, la chirurgie cardio-vasculaire, n'a pas été possible suite au manque d'équipements adéquats en RDC. Elle est décédée 4 jours après son diagnostic pendant qu'elle réalisait les formalités pour une évacuation sanitaire à l'étranger. La prise en charge d'urgence, notamment la chirurgie à coeur ouvert reste encore un challenge dans notre pays. Elle passe nécessairement par l'équipement de nos hôpitaux, surtout ceux de niveau tertiaire, et par l'amélioration du niveau socio-économique de nos populations