Korean J Leg Med.  2020 Feb;44(1):45-47. 10.7580/kjlm.2020.44.1.45.

Gastromalacia (Postmortem Gastric Perforation): Two Cases Reports

• Kim DJ
• Lee S

• KMID: 2471745
• DOI: http://doi.org/10.7580/kjlm.2020.44.1.45

Abstract

Gastromalacia refers to the postmortem acute autolytic erosion of the gastric wall. It should be distinguished from gastric perforations caused by antemortem injuries or other pathologic processes, such as ulcer perforations. It appears as a slimy brownish-black perforation of the gastric wall. The diagnosis is based on the presence of a typical macroscopic perforation in the fundic portion of the stomach, lack of vital reactions in the adjacent organs, and lack of clinical or autopsy evidence of trauma. Here, we report two cases of gastromalacia: one in a 53-year-old woman who died from severe head injury and another in a 2-year-old child who died from neglect by his father. Gastromalacia is a welldefined phenomenon, but due to its rarity in the practical work, it could be misdiagnosed as other causes of gastric perforation.

Keyword

Stomach; Autolysis; Artifacts; Postmortem changes

MeSH Terms

Artifacts
Autolysis
Autopsy
Child
Child, Preschool
Craniocerebral Trauma
Diagnosis
Fathers
Female
Humans
Middle Aged
Pathologic Processes
Postmortem Changes
Stomach
Ulcer

Figure

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  Fig. 1 (A) Large amount of epidural hematoma (100 mL) and linear skull fractures were seen in right brain hemisphere. (B) The gastric wall showed perforation by autolysis in fundic portion.

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  Fig. 2 A photography of the upper abdominal content showed a large defect in the gastric fundus without evidence of surrounding peritonitis. Undigested gastric contents were present.

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