Wischnewski revisited. The diagnostic value of gastric mucosal ulcers in hypothermic deaths

Hypothermia is defined as a subnormal body temperature. In this article, hypothermia refers to the loss of core temperature from exposure. When death results from hypothermia, a series of gastric mucosal erosions known as "Wischnewski ulcers" (1) frequently occur. In examining case material of the Onondaga County Medical Examiner's Office, a characteristic pattern of these ulcerations was seen that was indicative of severe physiologic stress and/or hypothermia. While not pathognomonic of hypothermia, the incidence of the erosions in a specific pattern has been closely associated with deaths in which hypothermia played a significant role. In hypothermia, the erosions, usually shallow and approximately 0.1-0.5 cm in diameter, are set in lines with roughly equidistant spacing, thereby forming a pattern of rectangles with the corners marked by the ulcerations.