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Vol. 87. Issue 3.
Pages 382-383 (July - September 2022)
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Vol. 87. Issue 3.
Pages 382-383 (July - September 2022)
Clinical image in Gastroenterology
Open Access
Extreme acute gastric dilation due to anorexia nervosa
Dilatación gástrica aguda extrema debida a anorexia nerviosa
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H. Ito
Corresponding author
itohirokan@yahoo.co.jp

Corresponding author at: División de Medicina Hospitalaria, Hospital de la Universidad de Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan. Tel: +81-29-853-3900.
, R. Ogawa
División de Medicina Hospitalaria, Hospital de la Universidad de Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan
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Acute gastric dilation is a rare condition associated with anorexia nervosa (the binge/purge subtype). It can be managed conservatively1 but sometimes results in fatal outcomes.2,3 A 40-year-old Japanese woman with a 15-year history of anorexia nervosa was admitted to our hospital because of abdominal pain and vomiting. She had eaten 5 kg of beef the day before but failed to throw it up at that time. Physical examination was notable for abdominal bloating, tenderness, and increased bowel sounds. Blood tests showed no abnormalities. A contrast-enhanced abdominal computed tomography scan revealed gastric dilation and portal venous gas, with no apparent gastrointestinal ischemia (Fig. 1). Her stomach volume was estimated at 5,000 ml on admission. She underwent gastrointestinal decompression using a nasogastric tube, which egested 2,000 ml of the stomach contents. She received conservative treatment, including bowel rest, fluid resuscitation, and pain control through intravenous acetaminophen. She had a bowel movement on day 6. Her epigastric pain resolved by day 8, and she started an oral diet. Her remaining clinical course was uneventful, and she was discharged on day 12.

Figure 1.

Contrast-enhanced abdominal computed tomography scan, revealing gastric dilation and portal venous gas, with no apparent gastrointestinal ischemia.

(0.08MB).
Ethical considerations

Written informed consent was obtained from the patient for publication of this article. Because the present work is a case report, no authorization by the institution’s ethics committee was required.

Financial disclosure

No financial support was received in relation to this article.

Conflict of interest

The authors declare that there is no conflict of interest.

References
[1]
A. Panyko, M. Vician, M. Dubovský.
Massive acute gastric dilatation in a patient with anorexia nervosa.
J Gastrointest Surg, 25 (2021), pp. 856-858
[2]
H. Ikegaya, M. Nakajima, K. Shintani-Ishida, et al.
Death due to duodenal obstruction in a patient with an eating disorder: a case report.
Int J Eat Disord, 39 (2006), pp. 350-352
[3]
E. Gyurkovics, B. Tihanyi, A. Szijarto, et al.
Fatal outcome from extreme acute gastric dilation after an eating binge.
Int J Eat Disord, 39 (2006), pp. 602-605

Please cite this article as: Ito H and R. Ogawa. Dilatación gástrica aguda extrema debida a anorexia nerviosa. Revista de Gastroenterología de México. 2022;87:382–383.

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