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Postmortem gastric perforation (gastromalacia) mimicking abusive injury in sudden unexplained infant death

Andrew N Laczniak1, Yutaka Sato, Marcus Nashelsky

  • 1Carver College of Medicine, University of Iowa, Iowa, IA, USA.

Pediatric Radiology
|May 25, 2011
PubMed

Insights

Gastromalacia, a postmortem gastric tissue autolysis, can cause perforation. Radiologists must distinguish this from antemortem bowel perforation to avoid misdiagnosis in infant deaths.

Area of Science:

  • Forensic Pathology
  • Radiology
  • Pediatric Autopsy

Background:

  • Gastromalacia is postmortem autolysis of gastric tissue leading to perforation.
  • It is a known entity among pathologists but infrequently recognized by radiologists.
  • Distinguishing postmortem from antemortem findings is crucial in forensic cases.

Observation:

  • A case of sudden unexplained infant death (SUID) is presented.
  • Postmortem radiographs revealed pneumoperitoneum.
  • Autopsy confirmed postmortem gastric perforation due to gastromalacia.

Findings:

  • Gastromalacia resulted in gastric perforation and pneumoperitoneum.
  • The findings were identified on postmortem radiographs.
  • Autopsy confirmed the cause of death and the gastric perforation.

Implications:

  • Radiologists must be aware of gastromalacia to prevent misinterpretation of postmortem findings.
  • Misdiagnosis could lead to incorrect conclusions regarding the cause of death, particularly in cases of suspected trauma.
  • Accurate identification aids in determining the timeline of events in infant deaths.

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