Fatal outcome from extreme acute gastric dilation after an eating binge

Endre Gyurkovics, Balázs Tihanyi, Attila Szijarto, Péter Kaliszky, Viktoria Temesi, S. A.S. Hedvig, Péter Kupcsulik

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Objective: A 22-year-old woman is presented with acute gastric dilation after an eating binge, who died of complications of acute reperfusion syndrome. Method: A young patient was admitted in our clinic with critical condition without any significant previous medical history. Her initial complaints - diarrhea, vomiting and abdominal pain - began after an enormous food intake. There was no history of medications or toxic substances. Physical examination showed a normally-developed, well-nourished female in severe distress with an extremely distended abdomen. Femoral pulses were absent. The US and CT scan showed a dilated stomach, extended into the pelvis, dislocating the intestinal organs and compressed the aorta and mesenteric veins. Results: Urgent laparotomy was performed. An enormously distended stomach was encountered without volvulus, obstruction or adhesions. About 11 liters of gastric content was removed gastrotomy and nasogastric tube. Following the gastric decompression, the mesenteric and femoral pulses reappeared. During the operation, the cardio-respiratory status was stabilized, but in the following 24 hours irreversible shock developed, possibly due to the reperfusion of the retroperitoneal organs and the lower extremities. In the postoperative period disseminated intravascular coagulopathy developed. In an uncontrollable state of diffuse bleeding, 36 hours post-operation, the patient died. In retrospective investigation, the family confessed that previous psychological treatments which aimed at her bulimic attacks. Conclusion: Acute gastric dilatation is very uncommon and is of various etiologies, two of these being anorexia nervosa and bulimia. Several cases documenting complications of gastric dilatation were published; however, such severe complications, involving gastric infarction and compression of the aorta with ischemic injury of the bowels and lower extremities, are rare.

Original languageEnglish
Pages (from-to)602-605
Number of pages4
JournalInternational Journal of Eating Disorders
Volume39
Issue number7
DOIs
Publication statusPublished - Nov 1 2006

Keywords

  • Bulimia
  • Disseminated intravascular coagulopathy
  • Eating binge
  • Gastric dilation

ASJC Scopus subject areas

  • Psychiatry and Mental health

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  • Cite this

    Gyurkovics, E., Tihanyi, B., Szijarto, A., Kaliszky, P., Temesi, V., Hedvig, S. A. S., & Kupcsulik, P. (2006). Fatal outcome from extreme acute gastric dilation after an eating binge. International Journal of Eating Disorders, 39(7), 602-605. https://doi.org/10.1002/eat.20281