Medicolegal Aspects of Post-Traumatic Gastroduodenal Ulcers: A Retrospective Study

• NCJ Number: 229287
• Journal: Journal of Forensic Sciences Volume: 54 Issue: 6 Dated: November 2009 Pages: 1423-1428
• Author(s): Slobodan Savic, M.D., Ph.D.; Radmila Stevanovic, M.D., M.A.; Djordje Alempijevic, M.D., Ph.D.; Stojan Petkovic, M.D., Ph.D.; Ivanka Baralic, M.D., Ph.D.
• Date Published: November 2009
• Length: 6 pages
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study assessed various characteristics of posttraumatic gastroduodenal ulcers (PGDU), based on postmortem data, along with their implications for medicolegal expertise in dealing with complications of various types of trauma.

Abstract

The research found that a patient with the highest risk for the development of PGDU is male, over 50 years old, injured in a traffic accident as a pedestrian who sustained multiple injuries that included damage to the cervical spinal cord and/or craniocerebral trauma, with ISS of approximately 16, and a survival period of up to 12 days. Another factor linked to PGDU was the development of posttraumatic complications, particularly pneumonia. Medicolegal expertise in cases of fatal trauma, compounded by the development of PGDU and associated complications, requires a precise scientific assessment of causal relationship between initial injury, PGDU, and fatal outcome. The medicolegal expert should explain all the risk factors leading to the development of posttraumatic ulcers and assess the contribution of this type of complication to the fatal outcome. In a small proportion of cases, particularly involving the elderly and those with pre-existing disease and/or other contributory factors, less serious injuries may lead to the development of acute gastroduodenal ulcers, sometimes with fatal consequences. The forensic pathologist may be asked to differentiate between the role of trauma and other risk factors in the development of acute gastroduodenal ulcers. This study reviewed all autopsies conducted at the Institute of Forensic Medicine in Belgrade (Serbia) over the 5-year period from 1996 to 2000. Out of the total sample of 5,197 autopsies, there were 887 trauma cases with a risk of developing PGDU, according to the relevant literature. The majority of these patients died after receiving treatment. PGDU were diagnosed at autopsy in 157 out of the 887 decedents. 5 tables, 1 figure, and 32 references