A completed gastromalacia after brainstem hemorrhage within 24 h: A case report and literature review

IF 1.3 4区医学 Q3 MEDICINE, LEGAL

Legal Medicine Pub Date : 2025-05-23 DOI:10.1016/j.legalmed.2025.102645

Jingzhou Yang , Longjin Zi , Fahui Duan , Ping Wang , Huan Liu

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Abstract

Gastromalacia is a postmortem feature characterized by rapid autolysis of the stomach, typically leading to a large rupture, predominantly in the gastric fundus. The pathophysiology of gastromalacia remains enigmatic. This study presents a novel case of a 32-year-old male who succumbed to respiratory failure after brainstem hemorrhage after sexual intercourse, which ultimately resulted in complete gastromalacia. Autopsy revealed hyperpyrexia (38.1 °C, 6 h post-mortem) and a substantial laceration (32 mm × 8 mm, irregular margins) in the inferior ventrolateral region of the pons on the right side. Additionally, the occurrence of complete gastromalacia within 24 h challenged our previous understanding that gastromalacia typically presents as a smaller lesion one day after death. Misdiagnosis of gastromalacia can arise from both forensic and clinical practices. This study raised the potential factors contributing to the rapid development of complete gastromalacia within 24 h. Through a literature review, we identified several key diagnostic indicators that may aid in distinguishing this condition, including a history of gastric ulceration, hyperthermia, and certain neurological disorders.

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脑干出血后24小时内完全性胃软化1例并文献复习

胃软化症是一种以胃快速自溶为特征的死后疾病，通常导致胃底出现大破裂。胃软化症的病理生理机制仍然是个谜。本研究报告一例32岁男性性交后脑干出血导致呼吸衰竭，最终导致完全性胃软化症。尸检显示高热（38.1°C，死后6小时），右侧脑桥下腹外侧区有明显撕裂伤（32 mm × 8 mm，边缘不规则）。此外，完全性胃软化症在24小时内的发生挑战了我们之前的理解，即胃软化症通常在死后一天出现较小的病变。胃软化症的误诊可能出现在法医和临床实践。本研究提出了导致完全性胃软化症在24小时内快速发展的潜在因素。通过文献综述，我们确定了几个关键的诊断指标，这些指标可能有助于区分这种疾病，包括胃溃疡史、高热史和某些神经系统疾病史。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Legal Medicine Nursing-Issues, Ethics and Legal Aspects

CiteScore

2.80

自引率

6.70%

发文量

119

审稿时长

7.9 weeks

期刊介绍： Legal Medicine provides an international forum for the publication of original articles, reviews and correspondence on subjects that cover practical and theoretical areas of interest relating to the wide range of legal medicine. Subjects covered include forensic pathology, toxicology, odontology, anthropology, criminalistics, immunochemistry, hemogenetics and forensic aspects of biological science with emphasis on DNA analysis and molecular biology. Submissions dealing with medicolegal problems such as malpractice, insurance, child abuse or ethics in medical practice are also acceptable.