An Exceptional Case of Acute Respiratory Failure Caused by Intra‐Thoracic Gastric Perforation Secondary to Overeating. Issue 1 (24th May 2018)

• Record Type: Journal Article
• Authors: di Luca, Alessandro; Ricci, Eleonora; Grassi, Vincenzo M.; Arena, Vincenzo; Oliva, Antonio
• Is Part Of: Journal of forensic sciences. Volume 64:Issue 1(2019)
• Page Start: 292
• Page End: 294
• Publication Date: 2018-05-24
• Subjects: forensic science -- forensic pathology -- autopsy -- anorexia nervosa -- bulimia -- overeating -- gastric perforation -- sexual abuse; Medical jurisprudence -- Periodicals; Forensic sciences -- Periodicals; Forensic Medicine -- Periodicals; Gerechtelijke geneeskunde; Gerechtelijke chemie; Gerechtelijke psychiatrie; 363.2505
• DOI: 10.1111/1556-4029.13825
• Languages: English
• ISSNs: 0022-1198

Abstract

Abstract: An 18‐year‐old female patient arrived at the emergency department complaining of abdominal pain and fullness after a heavy meal. Physical examination revealed she was filthy and cover in feces, and she experienced severe abdominal distension. She died in ED and a diagnostic autopsy examination was requested. At external examination, the pathologist observed a significant dilation of the anal sphincter and suspected sexual assault, thus alerting the Judicial Authority who assigned the case to our department for a forensic autopsy. During the autopsy, we observed anal orifice expansion without signs of violence; food was found in the pleural cavity. The stomach was hyper‐distended and perforated at three different points as well as the diaphragm. The patient was suffering from anorexia nervosa with episodes of overeating followed by manual voiding of her feces from the anal cavity (thus explaining the anal dilatation). The forensic pathologists closed the case as an accidental death.