Gastromalacia (Postmortem Gastric Perforation): Two Cases Reports

Abstract

eISSN 2383-5710 cCopyright 2020 by the Korean Society for Legal Medicine This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/ by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 45 Gastric perforation is uncommonly found during autopsy. This could be caused by perforated gastric ulcers, blunt abdominal traumas, tumors, cardiopulmonary resuscitation, or gastromalacia. Gastromalacia, originally described in the 18th century by John Hunter, is a postmortem artifact caused by the autolysis of gastric tissue due to the release of endogenous enzymes [1]. It is frequently encountered in the fundic portion of the stomach near the gastroesophageal junction. Occasionally, the left leaf of the diaphragm is also perforated by a ragged fenestration, leading to the escape of gastric contents into the pleural cavity. In addition, gastromalacia may also involve the distal esophagus, leading to perforation into the left pleural cavity [2]. These may lead to radiographic findings of pneumoperitoneum or pneumothorax. Here, we present two cases of gastromalacia with a literature review. A 53-year-old woman was discovered dead in her bedroom by her husband. At the midnight before her death, she had fallen down the basement staircase of a Karaoke room in a drunken state. Subsequently, she had returned to her house and fallen sleep. Her husband stated that she was sleeping when he left for his office at 07:40 but found her dead at 20:40 when he returned home. An autopsy performed the next day revealed a right temporo-parietal subgaleal hemorrhage with Korean J Leg Med 2020;44:45-47 https://doi.org/10.7580/kjlm.2020.44.1.45