Case Report

Fatal outcome from extreme acute gastric dilation after an eating binge

  1. Endre Gyurkovics MD1,*,
  2. Balázs Tihanyi MD1,
  3. Attila Szijarto MD1,
  4. Péter Kaliszky MD1,
  5. Viktoria Temesi MD2,
  6. Hedvig SAS MD1,
  7. Péter Kupcsulik MD, PhD, FACS1

Article first published online: 2 JUN 2006

DOI: 10.1002/eat.20281

Issue

International Journal of Eating Disorders

International Journal of Eating Disorders

Volume 39, Issue 7, pages 602–605, November 2006

Additional Information

How to Cite

Gyurkovics, E., Tihanyi, B., Szijarto, A., Kaliszky, P., Temesi, V., SAS, H. and Kupcsulik, P. (2006), Fatal outcome from extreme acute gastric dilation after an eating binge. Int. J. Eat. Disord., 39: 602–605. doi: 10.1002/eat.20281

Author Information

  1. 1

    1st Department of Surgery, Semmelweis University, Budapest, Hungary

  2. 2

    Department of Radiology, Semmelweis University, Budapest, Hungary

*1st Department of Surgery, Semmelweis University, 1082-HUN, Ülloi ùt 78, Budapest, Hungary

Publication History

  1. Issue published online: 13 OCT 2006
  2. Article first published online: 2 JUN 2006
  3. Manuscript Accepted: 14 DEC 2005

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Keywords:

  • gastric dilation;
  • eating binge;
  • bulimia;
  • disseminated intravascular coagulopathy

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. © 2006 by Wiley Periodicals, Inc. Int J Eat Disord 2006

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