Anorexic patient with extreme gastric dilatation

  • Emilio Dijan
  • Jakov Mihanovic
  • Nediljko Jovic
  • Edgar Domini
  • Ivan Rakvin
  • Tomislav Vanjak
Keywords: acute gastric dilatation, anorexia, binge, eating disorder


Acute gastric dilatation is a rare complication of anorexia nervosa binge incident which can result in gastric necrosis, perforation and even death. We present a case of a 30-year-old anorexic female patient with abdominal pain and vomiting after an overeating episode. Emergent CT scan revealed an extremely dilated stomach with wall pneumatosis together with clinical findings of generalized guarding of distended abdomen. After median laparotomy large livid stomach without perforation was found. Decompression was achieved through gastrotomy followed by gastroenteral and entero-enteral anastomosis. Recovery was complicated by iatrogenic pneumothorax after insertion of a central venous catheter on the right side and pleural effusion on the left side which mandated bilateral thoracic drainage. Anastomoses healed without complications in spite of low albumin level. Oral feeding route was employed with normal stool passage followed by an uneventful recovery.


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Hadley SJ, Walsh BT. Gastrointestinal disturbances in anorexia nervosa and bulimia nervosa. Curr Drug Targets CNS Neurol Disord 2003;2:1–9.

Turan M, Sen M, Canbay E, Karadayi K, Yildiz E. Gastric necrosis and perforation caused by acute gastric dilatation: report of a case. Surg Today 2003;33: 302–304.

Vandereycken W, Van Humbeeck I. Denial and concealment of eating disorders: a retrospective survey. Eur Eat Disord Rev 2008;16: 109–114.

Nakao A, Isozaki H, Iwagaki H, Kanagawa T, Takakura N, Tanaka N. Gastric perforation caused by a bulimic attack in an anorexia nervosa patient: report of a case. Surg Today 2000;30: 435–437.

Benini L, Todesco T, Dalle Grave R, Deiorio F, Salandini L, Vantini I. Gastric emptying in patients with restricting and binge/purging subtypes of anorexia nervosa. Am J Gastroenterol 2004;99: 1448–1454.

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: 6–10.

How to Cite
Dijan E, Mihanovic J, Jovic N, Domini E, Rakvin I, Vanjak T. Anorexic patient with extreme gastric dilatation. Acta Chir. Croat. [Internet]. 2013Aug.20 [cited 2022Aug.16];10(1):25-8. Available from:
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