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Franzoi M, Karic M, Groechenig HP. Abdominal Compartment Syndrome After Binge Eating. Gastroenterology 2022; 164:e13-e15. [PMID: 36509154 DOI: 10.1053/j.gastro.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Marco Franzoi
- Department of Internal Medicine and Gastroenterology, Academic Teaching Hospital Brothers of St John of God, St Veit an der Glan, Austria.
| | - Merima Karic
- Department of Internal Medicine and Gastroenterology, Academic Teaching Hospital Brothers of St John of God, St Veit an der Glan, Austria
| | - Hans Peter Groechenig
- Department of Internal Medicine and Gastroenterology, Academic Teaching Hospital Brothers of St John of God, St Veit an der Glan, Austria
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Wiedbrauck D, Wiedbrauck F, Hollerbach S. Endoscopic management of giant gastric dilatation in an anorexia nervosa patient after binge eating. ZEITSCHRIFT FUR GASTROENTEROLOGIE 2021; 60:1118-1123. [PMID: 34820803 DOI: 10.1055/a-1649-8131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Acute gastric dilatation is a rare and potentially life-threatening condition that may occur in patients suffering from anorexia nervosa after ingesting large amounts of food within a short period. Frequently, this condition is considered a surgical emergency due to subsequent occurrence of complications such as gastric necrosis or perforation.Here we report a case of a young female patient (23 years) with anorexia nervosa who presented with severe abdominal pain, nausea, and inability to vomit after a period of binge eating. Abdominal computed tomography revealed an extremely dilated stomach measuring 39.0 cm × 18.0 cm in size. Initial nasal decompression therapy using gastric tubes had failed. Due to the absence of complications, it was decided to treat her solely by endoscopic means under mechanical ventilation. After undergoing multiple overtube-assisted esophagogastroduodenoscopies (EGDs), she fully recovered eventually.This case demonstrates that interventional endoscopic treatment of a patient with uncomplicated acute gastric dilatation is feasible and safe, at least under general anesthesia. Hence, this option should be considered when sole gastric tube suction fails, and there is no indication of complications such as peritonitis, sepsis, perforation, or gastric ischemia. A more invasive and aggressive surgical procedure may be avoided in selected cases, and the length of hospital stay may be shortened.
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Affiliation(s)
- Damian Wiedbrauck
- Klinik für Gastroenterologie, Allgemeines Krankenhaus Celle, Celle, Germany
| | - Felix Wiedbrauck
- Klinik für Gastroenterologie, Allgemeines Krankenhaus Celle, Celle, Germany
| | - Stephan Hollerbach
- Klinik für Gastroenterologie, Allgemeines Krankenhaus Celle, Celle, Germany
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Fukae J, Kano M, Nakajima A, Fuse A, Eguchi H, Ashisawa K, Takanashi M, Hattori N, Shimo Y. Acute gastric dilatation is a potentially fatal complication in Parkinson's disease. Parkinsonism Relat Disord 2021; 85:69-71. [PMID: 33744692 DOI: 10.1016/j.parkreldis.2021.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
Affiliation(s)
- Jiro Fukae
- Department of Neurology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
| | - Masayoshi Kano
- Department of Neurology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
| | - Asuka Nakajima
- Department of Neurology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
| | - Atsuhito Fuse
- Department of Neurology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
| | - Hiroto Eguchi
- Department of Neurology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
| | - Karin Ashisawa
- Department of Pathology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan.
| | - Masashi Takanashi
- Department of Neurology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 113-8421, Japan.
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 113-8421, Japan.
| | - Yasushi Shimo
- Department of Neurology, Juntendo Nerima Hospital, 3-1-10 Takanodai, Nerima-ku, Tokyo, 177-8521, Japan; Department of Neurology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 113-8421, Japan; Department of Research and Therapeutics for Movement Disorders, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo, 113-8421, Japan.
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4
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Quaranta M, Orsini E, Zoli M, Ratti S, Maltoni L, Leonardi L, Manzoli L. An early scientific report on acromegaly: solving an intriguing endocrinological (c)old case? Hormones (Athens) 2020; 19:611-618. [PMID: 32002818 DOI: 10.1007/s42000-020-00175-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 01/22/2020] [Indexed: 10/25/2022]
Abstract
We present and discuss a late-nineteenth century clinical case described by Professor Taruffi in a scientific paper titled "Scheletro con prosopoectasia e tredici vertebre dorsali" (Skeleton with prosopoectasia and thirteen thoracic vertebrae). Taruffi could not explain the disproportionate skeletal and visceral growth, and the case could therefore be considered an unrecognized case of acromegaly. The anatomopathological specimens and the wax model cited in the paper are currently hosted at the "Luigi Cattaneo" Anatomical Wax Collection of Bologna University; however, some inaccuracies and uncertainties as to their attribution to the same case have remained to this day. The skeletal remains were examined macroscopically to investigate any structural abnormalities and pathological changes. In addition, thanks to archival, museum inventory and literature research, we documented the systematic relationship between the paper and the samples and were able to ascribe the abnormally dilated dried stomach, currently displayed in a different showcase, to the same case. This is, to our knowledge, the first case of acromegaly in the history of medical literature which also includes a visceral specimen. As far as we know, there are no reports of the occurrence of severe gastromegaly in patients with acromegaly. In view of this rare association and, to date, endocrinological research, we hypothesize a further pathogenic mechanism by which acromegaly could have induced this massive dilatation. Taruffi's work represents an immensely valuable scientific/artistic heritage and is still cited in contemporary endocrinological literature, demonstrating its relevant contribution to the historical evolution of the disease through the nineteenth and twentieth centuries.
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Affiliation(s)
- Marilisa Quaranta
- Department of Biomedical and Neuromotor Sciences, Human Anatomy section, University of Bologna, Bologna, Italy
| | - Ester Orsini
- Department of Biomedical and Neuromotor Sciences, Human Anatomy section, University of Bologna, Bologna, Italy.
| | - Matteo Zoli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
- Pituitary Unit - Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Stefano Ratti
- Department of Biomedical and Neuromotor Sciences, Human Anatomy section, University of Bologna, Bologna, Italy
| | - Lorenzo Maltoni
- Department of Biomedical and Neuromotor Sciences, Human Anatomy section, University of Bologna, Bologna, Italy
| | - Luisa Leonardi
- Department of Biomedical and Neuromotor Sciences, Human Anatomy section, University of Bologna, Bologna, Italy
- University Museum Network (SMA), University of Bologna, Bologna, Italy
| | - Lucia Manzoli
- Department of Biomedical and Neuromotor Sciences, Human Anatomy section, University of Bologna, Bologna, Italy
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Ahn JY, Kim JK. Delayed Pneumoperitoneum and Acute Pulmonary Edema Secondary to Acute Gastric Dilatation. Clin Endosc 2015; 48:566-9. [PMID: 26668807 PMCID: PMC4676672 DOI: 10.5946/ce.2015.48.6.566] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2015] [Accepted: 02/03/2015] [Indexed: 12/26/2022] Open
Abstract
Pneumoperitoneum caused by acute gastric dilatation (AGD) is a very rare complication. We report a case of pneumoperitoneum and acute pulmonary edema caused by AGD in a patient with Parkinson’s disease. A 78-year-old woman presented with pneumonia and AGD. We inserted a nasogastric tube and administered empirical antibiotics. We performed an endoscopy, and perforation or necrosis of the stomach and pyloric stenosis were not observed. Thirty-six hours after admission, the patient suddenly developed dyspnea and shock, and eventually died. We suspected the cause of death was pneumoperitoneum and acute pulmonary edema caused by AGD during the conservative treatment period. Immunocompromised patients with chronic illness require close observation even if they do not show any symptoms suggestive of complications. Even if the initial endoscopic or abdominal radiologic findings do not show gastric necrosis or perforation, follow-up with endoscopy is essential to recognize complications of AGD early.
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Affiliation(s)
- Jae Yun Ahn
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Jong Kun Kim
- Department of Emergency Medicine, Kyungpook National University School of Medicine, Daegu, Korea
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Acute Dilatation, Ischemia, and Necrosis of Stomach without Perforation. Case Rep Surg 2013; 2013:984594. [PMID: 24222883 PMCID: PMC3814073 DOI: 10.1155/2013/984594] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 08/27/2013] [Indexed: 12/14/2022] Open
Abstract
Acute gastric dilatation can have multiple etiologies which may lead to ischemia of the stomach. Without proper timely diagnosis and treatment, potentially fatal events such as gastric perforation, haemorrhage, and other serious complications can occur. Here we present a 36-year-old man who came to the casualty with pain abdomen and distension for 2 days. Clinically, abdomen was asymmetrically distended more in the left hypochondrium and epigastrium region. Straight X-ray abdomen showed opacified left hypochondrium with nonspecific gaseous distension of bowel. Exploratory laparotomy revealed dilated stomach with patchy gangrene over lesser curvature and fundic area. About 4 litres of brownish fluid along with semisolid undigested food particles was sucked out (mainly undigested pieces of meat). Limited resection of gangrenous areas and primary repair were done along with feeding jejunostomy. Necrosis of the stomach was confirmed on histopathology. The patient recovered well and was discharged on the tenth postoperative day.
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Acute gastric dilatation resulting in gastric emphysema following postpartum hemorrhage. Case Rep Surg 2012; 2012:230629. [PMID: 22779022 PMCID: PMC3388578 DOI: 10.1155/2012/230629] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2012] [Accepted: 04/12/2012] [Indexed: 11/17/2022] Open
Abstract
Acute gastric dilatation is a rare entity, with varying aetiologies the majority of which are benign. Delay in diagnosis and treatment could result in sequelae such as gastric emphysema (pneumatosis), emphysematous gastritis, gangrene, and perforation. Gastric emphysema as a result of a benign nongangrenous condition such as gastroparesis, adynamic ileus can be successfully managed conservatively. Here, we present an interesting case of acute gastric dilatation resulting in gastric emphysema following massive postpartum hemorrhage.
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Alagiakrishnan K, Frankel M. Silent acute gastric dilatation due to Salmonella infection in a diabetic elderly. Age Ageing 2011; 40:759-60. [PMID: 21893501 DOI: 10.1093/ageing/afr120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Acute gastric dilatation is a potentially life-threatening entity that has been reported in patients with some acute infections like pneumonia and staphylococcal bacteremia. We describe a case of acute gastric dilatation presenting atypically in a 65-year-old diabetic with Salmonella diarrhoea. By the fourth day of hospital admission the patient's abdomen was distended in the absence of pain, nausea or vomiting. An abdominal radiograph showed marked gastric dilatation with no evidence of obstruction or ileus. With nasogastric tube insertion and initiation of intravenous antibiotics, the stomach was back to normal size. It is likely that Salmonella infection was the major cause of acute gastric dilatation in this patient.
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Vettoretto N, Viotti F, Taglietti L, Giovanetti M. Acute idiopathic gastric necrosis, perforation and shock. J Emerg Trauma Shock 2011; 3:304. [PMID: 20930990 PMCID: PMC2938514 DOI: 10.4103/0974-2700.66564] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Accepted: 06/04/2010] [Indexed: 12/16/2022] Open
Affiliation(s)
- Nereo Vettoretto
- Department of General and Vascular Surgery, M. Mellini Hospital, Chiari (BS), Italy
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Tweed-Kent AM, Fagenholz PJ, Alam HB. Acute gastric dilatation in a patient with anorexia nervosa binge/purge subtype. J Emerg Trauma Shock 2011; 3:403-5. [PMID: 21063567 PMCID: PMC2966577 DOI: 10.4103/0974-2700.70774] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2009] [Accepted: 07/19/2010] [Indexed: 01/28/2023] Open
Abstract
Acute gastric dilatation is a rare complication of anorexia nervosa binge/purge subtype that results from gastrointestinal abnormalities, including decreased gastric motility and delayed gastric emptying. Early diagnosis and intervention is critical since delay may result in gastric necrosis, perforation, shock, and death. We report a 26-year-old female with anorexia nervosa binge/purge subtype, who presented with abdominal pain and nausea after a binge episode. Abdominal radiography and computed tomography showed a grossly dilated stomach measuring 32 cm × 17.9 cm consistent with acute gastric dilatation. She underwent exploratory laparotomy with gastrotomy and gastric decompression, and recovered uneventfully. Initially, the patient denied the binge episode, as many patients with eating disorders do, but later revealed an extensive history of anorexia nervosa binge/purge subtype. This case stresses the importance of obtaining a thorough history of eating disorders and maintaining a high index of suspicion for acute gastric dilatation in young women who present with abdominal pain and distention.
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Affiliation(s)
- Ailis M Tweed-Kent
- Division of Trauma, Emergency Surgery, and Critical Care, Department of Surgery, Massachusetts General Hospital, 55 Fruit St., Boston, MA, USA
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Koutelidakis I, Dragoumis D, Papaziogas B, Patsas A, Katsougianopoulos A, Atmatzidis S, Atmatzidis K. Gastric Perforation and Death after the Insertion of an Intragastric Balloon. Obes Surg 2008; 19:393-6. [DOI: 10.1007/s11695-008-9706-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2008] [Accepted: 09/10/2008] [Indexed: 01/26/2023]
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12
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Watanabe S, Terazawa K, Asari M, Matsubara K, Shiono H, Shimizu K. An autopsy case of sudden death due to acute gastric dilatation without rupture. Forensic Sci Int 2008; 180:e6-e10. [PMID: 18757145 DOI: 10.1016/j.forsciint.2008.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2008] [Revised: 07/28/2008] [Accepted: 07/28/2008] [Indexed: 12/29/2022]
Abstract
We report the first autopsy case of fatal gastric dilatation without rupture. A 31-year-old woman who lived alone was found dead in her living room. Despite being very thin, she showed marked abdominal distention. Autopsy and histological findings revealed that a severely distended stomach, of which walls notably thin and displayed transmural necrosis, occupied the entire abdominal cavity. Severe congestion was observed in the intestine and cecum. Theses findings suggest that bulimia nervosa together with anorexia nervosa resulted in rapid dilation of the stomach. We conclude that the cause of death was acute circulatory failure from hypovolemic shock that occurred following compression of the inferior vena cava and superior mesenteric vein, and by loss of circulatory volume to the third space.
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Affiliation(s)
- Satoshi Watanabe
- Department of Legal Medicine and of Pharmacy & Pharmacology, Asahikawa Medical College, Midorigaoka-higashi 2-1-1-1, Asahikawa 078-8510, Japan.
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