Anorexic patient with extreme gastric dilatation
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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