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Acute gastric dilatation in a patient with anorexia nervosa binge/purge subtype.

Tweed-Kent AM, Fagenholz PJ, Alam HB - J Emerg Trauma Shock (2010)

Bottom Line: Acute gastric dilatation is a rare complication of anorexia nervosa binge/purge subtype that results from gastrointestinal abnormalities, including decreased gastric motility and delayed gastric emptying.Early diagnosis and intervention is critical since delay may result in gastric necrosis, perforation, shock, and death.This case stresses the importance of obtaining a thorough history of eating disorders and maintaining a high index of suspicion for acute gastric dilatation in young women who present with abdominal pain and distention.

View Article: PubMed Central - PubMed

Affiliation: Division of Trauma, Emergency Surgery, and Critical Care, Department of Surgery, Massachusetts General Hospital, 55 Fruit St., Boston, MA, USA.

ABSTRACT
Acute gastric dilatation is a rare complication of anorexia nervosa binge/purge subtype that results from gastrointestinal abnormalities, including decreased gastric motility and delayed gastric emptying. Early diagnosis and intervention is critical since delay may result in gastric necrosis, perforation, shock, and death. We report a 26-year-old female with anorexia nervosa binge/purge subtype, who presented with abdominal pain and nausea after a binge episode. Abdominal radiography and computed tomography showed a grossly dilated stomach measuring 32 cm × 17.9 cm consistent with acute gastric dilatation. She underwent exploratory laparotomy with gastrotomy and gastric decompression, and recovered uneventfully. Initially, the patient denied the binge episode, as many patients with eating disorders do, but later revealed an extensive history of anorexia nervosa binge/purge subtype. This case stresses the importance of obtaining a thorough history of eating disorders and maintaining a high index of suspicion for acute gastric dilatation in young women who present with abdominal pain and distention.

No MeSH data available.


Related in: MedlinePlus

Abdominal radiograph showing a massively enlarged stomach, which occupies the entire abdominal cavity and displaces the transverse colon into the pelvis
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Figure 0001: Abdominal radiograph showing a massively enlarged stomach, which occupies the entire abdominal cavity and displaces the transverse colon into the pelvis

Mentions: Laboratory abnormalities included potassium 3.1 mEq/L, amylase 210 U/L, and lipase 114 U/L. Remaining chemistries and a complete blood count were normal. Abdominal plain film showed a grossly distended stomach filled with extensive food matter [Figure 1]. There was no abdominal free air. Abdominal computed tomography (CT) demonstrated an enlarged stomach, measuring 32 cm × 17.9 cm, displacing the small bowel into the right lower quadrant and the transverse colon into the pelvis [Figure 2].


Acute gastric dilatation in a patient with anorexia nervosa binge/purge subtype.

Tweed-Kent AM, Fagenholz PJ, Alam HB - J Emerg Trauma Shock (2010)

Abdominal radiograph showing a massively enlarged stomach, which occupies the entire abdominal cavity and displaces the transverse colon into the pelvis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2966577&req=5

Figure 0001: Abdominal radiograph showing a massively enlarged stomach, which occupies the entire abdominal cavity and displaces the transverse colon into the pelvis
Mentions: Laboratory abnormalities included potassium 3.1 mEq/L, amylase 210 U/L, and lipase 114 U/L. Remaining chemistries and a complete blood count were normal. Abdominal plain film showed a grossly distended stomach filled with extensive food matter [Figure 1]. There was no abdominal free air. Abdominal computed tomography (CT) demonstrated an enlarged stomach, measuring 32 cm × 17.9 cm, displacing the small bowel into the right lower quadrant and the transverse colon into the pelvis [Figure 2].

Bottom Line: Acute gastric dilatation is a rare complication of anorexia nervosa binge/purge subtype that results from gastrointestinal abnormalities, including decreased gastric motility and delayed gastric emptying.Early diagnosis and intervention is critical since delay may result in gastric necrosis, perforation, shock, and death.This case stresses the importance of obtaining a thorough history of eating disorders and maintaining a high index of suspicion for acute gastric dilatation in young women who present with abdominal pain and distention.

View Article: PubMed Central - PubMed

Affiliation: Division of Trauma, Emergency Surgery, and Critical Care, Department of Surgery, Massachusetts General Hospital, 55 Fruit St., Boston, MA, USA.

ABSTRACT
Acute gastric dilatation is a rare complication of anorexia nervosa binge/purge subtype that results from gastrointestinal abnormalities, including decreased gastric motility and delayed gastric emptying. Early diagnosis and intervention is critical since delay may result in gastric necrosis, perforation, shock, and death. We report a 26-year-old female with anorexia nervosa binge/purge subtype, who presented with abdominal pain and nausea after a binge episode. Abdominal radiography and computed tomography showed a grossly dilated stomach measuring 32 cm × 17.9 cm consistent with acute gastric dilatation. She underwent exploratory laparotomy with gastrotomy and gastric decompression, and recovered uneventfully. Initially, the patient denied the binge episode, as many patients with eating disorders do, but later revealed an extensive history of anorexia nervosa binge/purge subtype. This case stresses the importance of obtaining a thorough history of eating disorders and maintaining a high index of suspicion for acute gastric dilatation in young women who present with abdominal pain and distention.

No MeSH data available.


Related in: MedlinePlus