Thanatology: post-mortem gastric digestion artefact: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Thanatology: post-mortem gastric digestion artefact

Sample item

At autopsy of a man who died after a head injury, the fundus of the stomach and lower oesophagus are soft, brownish-black and thinned, with a perforation allowing gastric contents into the left pleural cavity. The edges show no hyperaemia, no inflammatory exudate and no haemorrhage. What is the correct interpretation?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Post-mortem digestion of the wall by gastric juice, an artefact

After death, gastric acid and pepsin can digest the stomach wall and adjacent oesophagus, especially when the stomach is full, producing softening (gastromalacia) and perforation. The absence of any vital reaction (no hyperaemia, exudate or haemorrhage) shows that the change is post-mortem. Ante-mortem lesions show inflammation or bleeding.

Option by option

  • A. Ante-mortem corrosive acid ingestion

    Ante-mortem corrosives cause congestion, haemorrhage and a vital reaction, with a history of ingestion.

  • B. Perforated peptic ulcer with peritonitis

    A perforated ulcer causes an inflamed, thickened edge and peritoneal inflammation.

  • C. Spontaneous rupture of the oesophagus (Boerhaave syndrome)

    Boerhaave tears cause a linear tear with mediastinal inflammation, not a softened thinned wall.

  • D. Post-mortem digestion of the wall by gastric juice, an artefact (correct)

    Correct. Lack of vital reaction with thin, brown-black softened wall indicates post-mortem digestion.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, Post-mortem digestion of the wall by gastric juice, an artefact. After death, gastric acid and pepsin can digest the stomach wall and adjacent oesophagus, especially when the stomach is full, producing softening (gastromalacia) and perforation.

Why is "Ante-mortem corrosive acid ingestion" not the answer?

Ante-mortem corrosives cause congestion, haemorrhage and a vital reaction, with a history of ingestion.

Why is "Perforated peptic ulcer with peritonitis" not the answer?

A perforated ulcer causes an inflamed, thickened edge and peritoneal inflammation.

Why is "Spontaneous rupture of the oesophagus (Boerhaave syndrome)" not the answer?

Boerhaave tears cause a linear tear with mediastinal inflammation, not a softened thinned wall.

What concept does this question test?

It tests Thanatology: post-mortem gastric digestion artefact in Forensic Medicine. The absence of any vital reaction (no hyperaemia, exudate or haemorrhage) shows that the change is post-mortem. Ante-mortem lesions show inflammation or bleeding.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Thanatology: post-mortem gastric digestion artefact?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.