Extensive gastric necrosis secondary to acute gastric dilatation: A case report

Murakami, Chikako; Irie, Wataru; Sasaki, Chizuko; Nakamaru, Naomi; Sakamoto, Momoko; Nagato, Junpei; Satoh, Fumiko

doi:10.1016/j.legalmed.2018.11.007

Cited by 11 publications

(8 citation statements)

References 12 publications

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“…Gastric necrosis can result from various causes, including overeating, direct damage to gastric walls, and gastric prolapse through a gastrostomy [ 1 , 2 , 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Gastric necrosis has been reported in various clinical scenarios, including gastrostomy prolapse, gastric banding surgery, inguinal hernia with entrapment of gastric walls, the rapid expansion of the stomach following a large meal, and patients who have undergone fundoplication surgery [1,2,[5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…Gastric necrosis is a rare condition that usually does not occur due to the abundant irrigation and collateral circulation of the stomach [ 1 ]. In fact, even ligation of major vessels does not typically lead to gastric necrosis [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Gastric Necrosis Due to Small Bowel Obstruction: A Case Report

Nuñez-Moreno¹,

Acosta-Gaxiola²

2023

Cureus

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Gastric necrosis is a rare entity due to the normal anatomy of the stomach; the irrigation of the stomach is abundant and has vast collateral irrigation that prevents necrosis from happening in normal situations. Gastric ischemia doesn't happen even if arterial occlusion occurs; however, a venous occlusion caused by an increase in intragastric pressure (measured >20 cm H2O in some experiments) that surpasses gastric venous pressure can precipitate necrosis of the stomach. Here we present the case of a 79-year-old woman with a history of chronic smoking, Alzheimer's dementia, systemic hypertension, hypothyroidism, chronic constipation, and a hysterectomy performed 25 years ago. An exploratory laparotomy was performed with the following findings: 3 liters of fecaloid fluid in the abdominal cavity, 70% necrosis of the stomach affecting major curvature and 80% of the fundus without compromising the cardia, a perforation in the anterior portion of the stomach with a diameter of 6 cm, a right femoral hernia with small bowel entrapment, intestinal obstruction with dilated small bowel; and intestinal necrosis of 7 cm of the ileum that was inside the femoral hernia. A vertical gastrectomy for the necrotic stomach and intestinal resection with termino-terminal anastomosis in the affected segment of the ileum were performed. The patient had a poor response to treatment and finally died 72 hours after surgery due to abdominal sepsis. This report shows that gastric necrosis, although rare, can be a cause of acute abdominal pain. It highlights the importance of a good clinical examination and imaging studies in detecting the causes of small bowel obstruction and offering prompt diagnosis and treatment to patients with small bowel obstruction.

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“…Gastric necrosis can result from various causes, including overeating, direct damage to gastric walls, and gastric prolapse through a gastrostomy [ 1 , 2 , 4 , 5 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Gastric Necrosis Due to Small Bowel Obstruction: A Case Report

Nuñez-Moreno¹,

Acosta-Gaxiola²

2023

Cureus

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“…Superior mesenteric artery (SMA) syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta (SMA-Ao)[ 1 - 4 ]. Left untreated, it can lead to potentially lethal complications, including sudden death, shock, pancreatitis, gastric perforation, malnutrition and hypokalemia[ 5 - 9 ]. Hence, early diagnosis and treatments are imperative[ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Dynamic ultrasonography for optimizing treatment position in superior mesenteric artery syndrome: Two case reports and review of literature

Hasegawa,

Oka,

Awoniyi

et al. 2024

World J Gastroenterol

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BACKGROUND Superior mesenteric artery (SMA) syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta (SMA-Ao). Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome, individual variations in the optimal patient position have been noted. In this report, we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each patient. CASE SUMMARY Case 1: A 90-year-old man with nausea and vomiting. Following diagnosis of SMA syndrome by computed tomography (CT), ultrasonography (US) revealed the SMA-Ao distance in the supine position (4 mm), which slightly improved in the lateral position (5.7–7.0 mm) without the passage of duodenal contents. However, in the sitting position, the SMA-Ao distance was increased to 15 mm accompanied by improved content passage. Additionally, US indicated enhanced passage upon abdominal massage on the right side. By day 2, the patient could eat comfortably with the optimal position and massage. Case 2: An 87-year-old woman with vomiting. After the diagnosis of SMA syndrome and aspiration pneumonia by CT, dynamic US confirmed the optimal position (SMA-Ao distance was improved to 7 mm in forward-bent position, whereas it remained at 5 mm in the supine position). By day 7 when her pneumonia recovered, she could eat with the optimal position. CONCLUSION The optimal position for SMA syndrome varies among individuals. Dynamic US appears to be a valuable tool in improving patient outcomes.

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“…[7] Acute gastric distension (AGD) is a condition involving stomach dilatation accompanied by the loss of gastric wall tension, and filling of the GI tract with gas, secretions, and food Park and Nho • Medicine (2023) 102:28 Medicine material, without structural obstruction. [8] AGD may occur in patients with pancreas pathologies such as acute pancreatitis, diabetic neuropathy or ketoacidosis, and eating disorders such as anorexia nervosa and bulimia nervosa, or after trauma or peritoneal surgery. [9][10][11][12] AGD is occasionally accompanied by gastric outlet obstruction due to peptic ulcer disease and gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

Abdominal compartment syndrome caused by severe acute gastric distension in a patient with COVID-19: A case report

Park

Nho

2023

Medicine

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Rationale: The clinical manifestation of coronavirus disease 2019 (COVID-19) ranges from asymptomatic to critical. The gastrointestinal (GI) tract is involved in the early stages of the disease and is recognized as an important entry site for the virus. Consequently, GI manifestations are common in patients with COVID-19; however, the GI presentation of COVID-19 in relation to bowel dilatation has rarely been reported. Here, we report a case of acute severe gastric distension resulting in aortic compression and abdominal compartment syndrome (ACS) in a patient with COVID-19. Patient concerns: A 72-year-old male presented to the emergency department (ED) with severe abdominal distension. The patient had been confirmed to have COVID-19 5 days prior to the visit. Diagnoses: Computed tomography revealed critical abdominal distension with severe gastric dilatation, accompanied by compression of the abdominal aorta and distal thrombosis formation. Interventions: Intravenous fluid resuscitation and support with inotropic agents were initiated immediately, and a large amount of gastric content was evacuated via a nasogastric (NG) tube. Outcome: Finally, the patient was discharged after 12 days of admission without obvious complications. Lessons: ACS is critical, which can be caused by a severe degree of acute gastric distension (AGD). Evacuation of the intraluminal contents is the most efficient management strategy. Prognosis is poor, and most previous studies of the transition from AGD to ACS have reported unfavorable outcomes.

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Extensive gastric necrosis secondary to acute gastric dilatation: A case report

Cited by 11 publications

References 12 publications

Gastric Necrosis Due to Small Bowel Obstruction: A Case Report

Gastric Necrosis Due to Small Bowel Obstruction: A Case Report

Dynamic ultrasonography for optimizing treatment position in superior mesenteric artery syndrome: Two case reports and review of literature

Abdominal compartment syndrome caused by severe acute gastric distension in a patient with COVID-19: A case report

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