Medicolegal aspects of post-traumatic gastroduodenal ulcers: a retrospective study.
Retrospective examination of 5-year autopsy material showed the presence of posttraumatic gastroduodenal ulcers (PGDU) in 17.7% of decedents deemed to be at risk. They were more common in males (77%) and in patients aged over 50. In the majority of cases (76%) the survival period was < 12 days; in 16.5% it was < 48 h. PGDU developed most commonly in victims of polytrauma and isolated craniocerebral injury, with ISS values > or = 16; patients with spinal cord injuries were at greatest risk. Most frequently affected was the stomach, exhibiting numerous, usually superficial lesions, while solitary acute and exacerbated chronic peptic ulcers were more common in the duodenum. Complications of PGDU developed in 40% of cases, mostly in the form of hemorrhage; in 20% of cases PGDU have contributed to death. Medicolegal aspects of PGDU are, most frequently, concerned with the causal relationship between trauma, PGDU, and fatal outcome, as well as the potential for allegations of medical negligence.
Institute of Forensic Medicine, Medical School, University of Belgrade, Serbia. brana.s@eunet.rs
Slobodan
S
Savic
Radmila
R
Stevanovic
Djordje
D
Alempijevic
Stojan
S
Petkovic
Ivanka
I
Baralic
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D049429:Forensic Pathology; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000209:etiology* / Q000401:mortality* / Q000473:pathology; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D055771:Serbia; D017678:Sex Distribution; D013514:Surgical Procedures, Operative; D014947:Wounds and Injuries / Q000401:mortality* / Q000601:surgery