Hepatic viscerotomy: its contribution to the study of regional nosology

As a part of a routine yellow fever surveillance program going on in the south of Bahia State, Brazil, liver fragments were obtained through postmortem viscerotomy from 702 individuals who died after presenting acute febrile illness from 1981 up till 1991. Instead of being only screened for the presence of yellow fever, the liver tissue was thoroughly evaluated by histopathology. More than a third of the cases exhibited marked and diffuse steatosis occurring in malnourished infants and young children. Hepatic fibrosis, granulomatous disease compatible with disseminated tuberculosis, advanced schistosomiasis, chronic alcoholic injury, chronic hepatitis and cirrhosis were also frequently observed. A miscellaneous group of hepatic pathological processes were also recognized, which included such diverse entities as Hodgkin's disease, glycogenosis, sickle-cell disease, hepatocarcinoma, etc. Only 124 (17.7 per cent ) cases showed normal hepatic histology. The wide possibility of histological diagnoses strongly indicates that the material obtained by viscerotomy can be further explored by an interested pathologist, to help in the understanding of nosology and epidemiology, concerning remote geographic areas where viscerotomy is being routinely performed