Vertebral column kyphoscoliosis and unexpected death.
A case of spontaneous gastric perforation is reported in a 75-year-old woman due to massive hemorrhaging from a benign gastric ulcer. Blood was prevented from leaving the stomach due to posterior displacement and rotation of the stomach associated with marked underlying vertebral column kyphoscoliosis. Significant deformity of the spine had caused malpositioning of the stomach as a result of the abnormal shape of the peritoneal and chest cavities. This in turn had led to mechanical obstruction and prevented egress of blood arising from a bleeding arteriole in the base of a chronic gastric ulcer. Rapid distension had resulted from the inability to spontaneously decompress the stomach, which in turn had led to rupture.
Guddat
Saskia S
SS
Institute of Legal Medicine and Forensic Sciences, Charité-Universitätsmedizin Berlin, Turmstr. 21 (Haus L), 10559 Berlin, Germany.
Tsokos
Michael
M
Schalinski
Sarah
S
Byard
Roger W
RW
D000368:Aged; D005260:Female; D049429:Forensic Pathology; D013271:Gastric Dilatation / Q000209:etiology*; D006801:Humans; D007738:Kyphosis / Q000150:complications*; D010438:Peptic Ulcer Hemorrhage / Q000209:etiology*; D010439:Peptic Ulcer Perforation / Q000209:etiology; D010529:Peritoneal Cavity / Q000002:abnormalities; D012399:Rotation; D012421:Rupture / Q000209:etiology; D012600:Scoliosis / Q000150:complications*; D013270:Stomach / Q000002:abnormalities*; D013276:Stomach Ulcer / Q000150:complications; D013909:Thorax / Q000002:abnormalities
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