Diseases of the urogenital and digestive organs caused 13% of the sudden and unexpected deaths in 1937.59 Nowadays, such cases are uncommon, with possibly the most common entity a massive hematemesis due to esophageal varices complicating cirrhosis of the liver. Occasionally, one will see a death following a duodenal ulcer eroding into a major blood vessel with massive GI hemorrhage. There are occasional deaths caused by peritonitis from a perforated duodenal ulcer or an acute peritonitis. These latter deaths are more common in alcoholics and psychotic patients on heavy doses of antip-sychotic medications that could mask the symptoms of these conditions and the patients' awareness of their illness.
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