Revisit of gastromalacia: a report of three cases and review of the literature

Gastromalacia, a postmortem dissolution of the stomach, is caused by endogenous enzymes resulting in thinning and softening of the stomach wall with focal perforation. Thus, identifying gastromalacia and differentiating it from other causes of gastric perforation is essential to avoid misdiagnosis. Herein, three cases of gastromalacia are described. The victims died due to hyperthermia, leukemia complicated by cerebral hemorrhage, and asphyxia due to inhaled vomitus, respectively. The macroscopic and microscopic appearance in three cases indicated gastromalacia, although multiple factors confused the diagnosis. Furthermore, the differential diagnosis and the underlying mechanism are discussed.