Gastric Perforation Caused by Acute Massive Gastric Dilatation: Report of a Case

Abstract

Gastric necrosis with perforation caused by acute gastric dilatation is an extremely rare presenting complication. We experienced a rare case of gastric perforation caused by acute massive gastric dilatation after a binge-eating episode. A 23-year old woman was admitted with a chief complaint of acute abdominal pain with severe abdominal distension after a heavy meal. She had no history of abdominal surgery. On computed tomography, the stomach and the duodenum were severely dilated with food content. There was no tumor in the peritoneal cavity. Despite conservative management, the patient’s symptoms were aggravated after 2 days and she underwent an emergent laparotomy. Laparotomy revealed that the stomach and the second portion of the duodenum were severely dilated. There was a small perforation with surrounding necrotic change on the fundus of the stomach. We performed decompression through a gastrotomy and bypass duodeno-jejunostomy. The patient’s postoperative recovery was uneventful. Physicians should be aware that binge-eating habits may cause acute massive gastric dilatation in the absence of a typical eating disorder history. J Med Cases. 2012;3(5):286-289 doi: https://doi.org/10.4021/jmc635w