Medicolegal Aspects of Post-traumatic Gastroduodenal Ulcers: A Retrospective Study*

Authors


  • *

    Presented at the 60th Annual Meeting of the American Academy of Forensic Sciences, Feb. 18–23, 2008, in Washington, DC.

Additional information and reprint requests:
Slobodan Savic, M.D., Ph.D.
Institute of Forensic Medicine
School of Medicine, University of Belgrade
Deligradska 31a
11000 Belgrade
Serbia
E-mail: brana.s@eunet.rs

Abstract

Abstract:  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 ≥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.

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