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Autopsy practice in patients with morbid obesity

George St. Stoyanov, Deyan Dzhenkov, Lilyana Petkova



Obesity, as defined by the World Health Organization (WHO), is a body mass index (BMI) of 30 kg/m2 or more. Obesity itself is further categorized as class 1 - BMI of 30-34 kg/m2, class 2 - BMI of 35-40 kg/m2, and class 3 or extreme obesity is defined as a BMI greater than 40 kg/m2.

Materials and Methods

From a total of 60 autopsies, 50 were adult autopsies and 10% (n=5) complied with the WHO criteria of extreme obesity, BMI above 40 kg/m2.


Three of the patients were male and two - female. BMI varied from 45 to 97 kg/m2, with the most obese patient weighing 320 kg. Age varied from 38 to 53 years. Gross evaluation and histological changes revealed that all of the patients had hypertension and congestive heart failure with reverse type nutmeg liver and cyanosis of the spleen and kidneys, with one of the patients having pelvic and deep vein thrombosis.


Autopsies of patients with morbid obesity represent an extreme difficulty for the pathologist based on the inadequacy of the armamentarium for such patients, extreme physical workload, and the number of direct complications of obesity that need to be observed.


autopsy, morbid obesity, BMI, complications

Full Text


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