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Acute gastric dilatation causing fatal outcome in a young female with eating disorder: a case report.

Youm SM, Kim JY, Lee JR - Korean J Anesthesiol (2015)

Bottom Line: Though anesthesia was induced without event, abrupt hemodynamic collapse developed just after the operation started.In spite of active resuscitation for 29 min, the patient did not recover and expired.As the incidence of eating disorders is increasing, anesthesiologists should keep in mind the possibility of abdominal compartment syndrome in patients with a recent history of binge eating, and prepare optimal anesthetic and resuscitation remedies against sudden deteriorations of a patient's condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
A 21-year-old female with a history of bulimia nervosa came to the emergency room due to severe abdominal pain after excessive eating five hours previously. On arrival at the emergency room, extreme abdominal distension was detected and the patient's legs changed color. Computed tomography suggested severe gastric dilatation, so abdominal compartment syndrome was suspected and an emergent laparotomy was supposed to be conducted. Though anesthesia was induced without event, abrupt hemodynamic collapse developed just after the operation started. In spite of active resuscitation for 29 min, the patient did not recover and expired. As the incidence of eating disorders is increasing, anesthesiologists should keep in mind the possibility of abdominal compartment syndrome in patients with a recent history of binge eating, and prepare optimal anesthetic and resuscitation remedies against sudden deteriorations of a patient's condition.

No MeSH data available.


Related in: MedlinePlus

(A) Simple upright abdominal radiography shows that markedly distended stomach with food materials occupying almost entire abdominal cavity. Note that there is moderate amount of pneumoperitoneum, suggesting gastric perforation. (B) Markedly distended stomach with food material. Note that pneumatosis along the gastric wall, suggesting infarction (white arrows).
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Figure 1: (A) Simple upright abdominal radiography shows that markedly distended stomach with food materials occupying almost entire abdominal cavity. Note that there is moderate amount of pneumoperitoneum, suggesting gastric perforation. (B) Markedly distended stomach with food material. Note that pneumatosis along the gastric wall, suggesting infarction (white arrows).

Mentions: While visiting the emergency room, her abdomen looked markedly distended. She suffered from nausea and retching but was unable to vomit. Her vital signs upon arrival at the emergency room were as follows: Blood pressure 128/83 mmHg, pulse 78 beats/min, respiratory rate 18 breaths/min, and a body temperature of 36.8℃. Chest AP and simple abdomen flat upright view revealed that the stomach was full of food material with air-fluid level. Computed tomography showed a massive gastric overdistension with pneumoperitoneum (Fig. 1). A Foley catheter was inserted into the bladder cavity, and the amount of urine there was nearly zero (Fig. 2). Levin tube insertion revealed that the material in her stomach was incompletely digested and that drainage was not effective. The initial complete blood cell count was within normal ranges, including a hemoglobin level of 12 g/dl. Blood chemistry had no unusual characteristics except doubly elevated levels of amylase and lipase.


Acute gastric dilatation causing fatal outcome in a young female with eating disorder: a case report.

Youm SM, Kim JY, Lee JR - Korean J Anesthesiol (2015)

(A) Simple upright abdominal radiography shows that markedly distended stomach with food materials occupying almost entire abdominal cavity. Note that there is moderate amount of pneumoperitoneum, suggesting gastric perforation. (B) Markedly distended stomach with food material. Note that pneumatosis along the gastric wall, suggesting infarction (white arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4384409&req=5

Figure 1: (A) Simple upright abdominal radiography shows that markedly distended stomach with food materials occupying almost entire abdominal cavity. Note that there is moderate amount of pneumoperitoneum, suggesting gastric perforation. (B) Markedly distended stomach with food material. Note that pneumatosis along the gastric wall, suggesting infarction (white arrows).
Mentions: While visiting the emergency room, her abdomen looked markedly distended. She suffered from nausea and retching but was unable to vomit. Her vital signs upon arrival at the emergency room were as follows: Blood pressure 128/83 mmHg, pulse 78 beats/min, respiratory rate 18 breaths/min, and a body temperature of 36.8℃. Chest AP and simple abdomen flat upright view revealed that the stomach was full of food material with air-fluid level. Computed tomography showed a massive gastric overdistension with pneumoperitoneum (Fig. 1). A Foley catheter was inserted into the bladder cavity, and the amount of urine there was nearly zero (Fig. 2). Levin tube insertion revealed that the material in her stomach was incompletely digested and that drainage was not effective. The initial complete blood cell count was within normal ranges, including a hemoglobin level of 12 g/dl. Blood chemistry had no unusual characteristics except doubly elevated levels of amylase and lipase.

Bottom Line: Though anesthesia was induced without event, abrupt hemodynamic collapse developed just after the operation started.In spite of active resuscitation for 29 min, the patient did not recover and expired.As the incidence of eating disorders is increasing, anesthesiologists should keep in mind the possibility of abdominal compartment syndrome in patients with a recent history of binge eating, and prepare optimal anesthetic and resuscitation remedies against sudden deteriorations of a patient's condition.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, Korea. ; Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
A 21-year-old female with a history of bulimia nervosa came to the emergency room due to severe abdominal pain after excessive eating five hours previously. On arrival at the emergency room, extreme abdominal distension was detected and the patient's legs changed color. Computed tomography suggested severe gastric dilatation, so abdominal compartment syndrome was suspected and an emergent laparotomy was supposed to be conducted. Though anesthesia was induced without event, abrupt hemodynamic collapse developed just after the operation started. In spite of active resuscitation for 29 min, the patient did not recover and expired. As the incidence of eating disorders is increasing, anesthesiologists should keep in mind the possibility of abdominal compartment syndrome in patients with a recent history of binge eating, and prepare optimal anesthetic and resuscitation remedies against sudden deteriorations of a patient's condition.

No MeSH data available.


Related in: MedlinePlus