A Case of Multiple Gastric Mucosa Lacerations in Near Drowning

ABSTRACT

The causes of complicated upper gastrointestinal bleeding in near-drowning have been known to be stress-induced gastritis, gastric ulcer, Mallory-Weiss syndrome, or Boerhaave syndrome. However, gastric mucosa laceration has often been observed in a drowned body's autopsy. Gastric fundus is the most common site of gastric mucosa lacerations, and the number of lacerations is almost always less than three. Reflex gasping in drowning leads to passive vigorous vomiting, the mechanical force of which causes gastric mucosa laceration. Gastric mucosa laceration is an important forensic clue in autopsy because it means that the victim was drowned alive or was abandoned after being murdered. However, gastric mucosa laceration has rarely been observed in a drowning survivor. We report a neardrowning case of a 9-year-old boy, who had multiple gastric mucosa lacerations treated by endoscopic hemostatic procedure. In our case, we suspect abdominal blunt trauma also to be another cause of gastric mucosa laceration because of uncommon site of the laceration and the large number of lesions. We also present a literature review.