Elsevier

Legal Medicine

Volume 5, Issue 1, March 2003, Pages 60-64
Legal Medicine

Case report
Sudden unexpected death due to rupture of the stomach

https://doi.org/10.1016/S1344-6223(02)00034-2Get rights and content

Abstract

We report a case of sudden unexpected death due to rupture of the stomach. A 49-year-old man was found dead in a public lavatory. Autopsy findings revealed two rupture wounds measuring 14 cm and 6 cm located in the fundus of stomach at the side of the greater curvature despite of any superficial injury. The deceased had an ulcer in the lesser curvature of stomach, and dilation in this area was expected to be impaired. Under this condition, excessive over-eating resulting in over-extension of the stomach wall at the greater curvature was speculated to have caused stomach rupture.

Introduction

Gastrorrhexis or stomach rupture is a relatively rare condition. A search of the Japanese as well as foreign literature of the past 50 years yielded only 47 reports on gastrorrhexis of unknown etiology. In this paper, we report our experience with a case of sudden death due to gastrorrhexis suspected to be induced by excessive eating and we review previous reports on this subject as well.

Section snippets

Case report

A 49-year-old security guard was found dead in a public lavatory. He had a history of chronic gastritis and had complained of abdominal symptoms, described as not being severe, 4 h prior to the estimated time of death. On external examination, there was no hematemesis or vomitus around the body. A pale, reddish purple livor appeared at the back of the deceased. This livor was faded by digital pressure relatively rapidly. Moderate postmortem rigor was observed in the jaw, neck, shoulder joint,

Discussion

According to our literature review, a total of 62 cases of ‘spontaneous rupture of the stomach’ were reported in 47 articles in the past 50 years. In those cases, there was a female predominance with a male to female ratio of 1:4. The age of onset ranged from 16 to 86 years, with the highest prevalence in the sixties. Ruptures were located in the lesser curvature of stomach in 73% of the cases, were solitary in 87%, and were larger than 6 cm in only 22% of the cases. Several features such as

Acknowledgements

We express our sincere gratitude to Professor Demon C. Herbert (Professor of Department of Cellular and Structural Biology, The University of Texas, Health Science Center at San Antonio, Texas) for critically reviewing this manuscript.

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