Acute Gastric Dilatation and Necrosis: a Case Report

Abstract

Massive gastric dilatation with necrosis and rupture is a very rare event. Here we describe the case of a 13-year-old girl with acute gastric dilatation, infarction, necrosis and perforation. It began with acute abdominal pain, but an absence of vomiting after eating a heavy meal. Laparotomy showed massive gastric dilatation with infarction and perforation. Early diagnosis is essential to reduce morbidity and mortality, and therefore treatment must be started promptly.

Gastric Necrosis due to Acute Massive Gastric Dilatation

“…Resection and esophagojejunostomy are successful under optimal conditions [3, 9]. In cases of delayed treatment or with generalized peritonitis, decompression and drainage are recommended in addition to resection [11]. Total gastrectomy and esophagojejunostomy were performed on our case because necrosis was present in the fundus and greater curvature of the corpus and perforation was absent.…”

Acute gastric dilatation causing respiratory distress

“…An elevated white cell count and deranged renal function, as in the second case, are ominous findings as they may be indicative of pressure necrosis and ischaemia of the gastric lining and ensuing complications. 5 Perforation and sepsis have been widely reported, 7 as has abdominal compartment syndrome through rapid elevation of the intra-abdominal pressure by >20 mmHg. 4 Type I or II respiratory failure can arise through aspiration or diaphragmatic splinting, respectively.…”

Acute Massive Gastric Dialation—A Case Report

“…Complications much known are perforation and sepsis. Mortality rate of up to 80 has been reported in cases of gastric ischemia and perforation [11]. Immediate identification and management are important to prevent complications such as gangrene, perforation, gastric emphysema (pnematosis) and emphysematous gastritis.…”