1/61. Gastric perforation caused by a bulimic attack in an anorexia nervosa patient: report of a case.We report a rare case of gastric perforation due to a bulimic attack in a 17-year-old girl suffering from anorexia nervosa. She was admitted to our hospital with the chief complaint of abdominal pain following bulimia. Initially, her symptoms were reduced after drainage using a nasogastric tube. Eight hours later, however, she fell into a state of preshock. Abdominal radiography revealed subphrenic free air. We diagnosed the patient as having diffuse peritonitis. At laparotomy, the stomach was dilated and necrotic with perforation. Almost the entire stomach was resected. Postoperatively, the patient recovered uneventfully. We should therefore be aware of this condition when treating patients with anorexia nervosa who complain of abdominal pain.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
2/61. Gastric wall erosion by an amebic liver abscess in a 3-year-old girl.The occurrence of an amebic liver abscess (ALA) rupturing into the stomach is reported. ALAs in children can have atypical presentations, resulting in delayed diagnosis and increased morbidity and mortality. Timely treatment is usually followed by complete recovery.- - - - - - - - - - ranking = 0.5keywords = stomach (Clic here for more details about this article) |
3/61. shock and dyspnea after cardiopulmonary resuscitation: a case of iatrogenic gastric rupture.Rupture of the stomach is a rarely reported complication of cardiopulmonary resuscitation. The number of cases reported in the literature since 1970 does not exceed 30. We present a recent case of a young woman submitted to cardiopulmonary resuscitation in whom a gastric rupture gave rise to massive pneumoperitoneum with haemodynamic shock and respiratory failure. Major distension of the abdomen and an extensive subcutaneous emphysema were present. After re-establishing the haemodynamic conditions and a diagnostic spiral thoracic-abdomen CT scan, an emergency laparoptomy was performed. We found two linear defects of the lesser curvature of the stomach, which were treated by closure with a primary interrupted two-layer suture. The postoperative recovery was uneventful. Iatrogenic gastric rupture carries a high risk of mortality. A prompt diagnosis and emergency surgical repair are essential for patient survival.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
4/61. Gastric incarceration and perforation following posttraumatic diaphragmatic hernia.We report the case of a 36-year-old male patient who developed gastric incarceration and perforation in a diaphragmatic hernia 8 months after an automobile accident. During emergency surgery, protrusion of the stomach into the thoracic cavity and perforation on the anterior aspect of the stomach were noted. The gastric perforation and the diaphragmatic defect were closed. During the postoperative course, the patient developed sepsis and coagulopathy that subsided following medical therapy. In order to prevent severe complications, surgery is indicated as soon as conclusive diagnosis is made.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
5/61. Gastric necrosis and perforation as a complication of splenectomy. Case report and related references.necrosis of the stomach after isolated splenectomy with the formation of gastrocutaneous fistula is a rare event that occurs in less than 1% of splenectomies. It is more frequent when the removal of the spleen is done because of hematological diseases. Its mortality index can reach 60% and its pathogenesis is controversial, as it may be attributed both to direct trauma of the gastric wall and to ischemic phenomena. Although the stomach may exhibit exuberant arterial blood irrigation, anatomical variations can cause a predisposition towards the appearance of potentially ischemic areas, especially after ligation of the short gastric vessels around the major curvature of the stomach. Once this is diagnosed in the immediate postoperative period, it becomes imperative to reoperate. The surgical procedure will depend on the conditions of the peritoneal cavity and patient's clinic status. The objective of this study was to report on the case of a patient submitted to splenectomy because of closed abdominal traumatism, who then presented peritonitis and percutaneous gastric fistula in the post-operative period. During the second operation, perforations were identified in anterior gastric wall where there had been signs of vascular stress. The lesion was sutured after revival of its borders, and the patient had good evolution. Prompt diagnosis and immediate treatment of this unusual complication are needed to reduce its high mortality rate.- - - - - - - - - - ranking = 1.5keywords = stomach (Clic here for more details about this article) |
6/61. Gastric rupture caused by acute gastric distention in non-neonatal children: clinical analysis of 3 cases.OBJECTIVE: To study gastric rupture, a progressive, rapid and high mortality condition, caused by acute gastric distention (GRAGD) and its appropriate diagnosis and treatment. methods: The etiology, pathology, clinical manifestations and experiences in 3 children with GRAGD were reviewed. RESULTS: Case 1: After diagnosing GRAGD and stabilizing her shock with massive fluid replacement, gastrostomy was performed. Her postoperative course was uneventful because of fasting, suction, fluid infusion, correction of acidosis and supporting nutrition. Case 2: After diagnosing gastric distention which subsided with conservative therapy for 9 days, she suddenly had gastric rupture when she had not eaten for 6 days. She died of shock and had no chance for surgery. Case 3: The patient had sudden abdominal pain, distention and vomiting with severe shock for 4 days. Emergency surgery found gastric rupture and the method was the same as Case 1. The patient survived but has brain impairment. Case 1 and 3 showed multifocal transmural necrosis. CONCLUSIONS: Symptoms like overeating, bulimia, changes in kind of food, X-ray showing large distended stomach and massive pneumoperitoneum were seen after gastric rupture and can help to diagnose this condition. Clinical course of gastric distention with toxic shock progresses rapidly, however subsequent gastric rupture exacerbates the shock and makes the treatment difficult treatment. It is extremely important that a laparotomy be performed at once after stabilizing shock with massive fluid replacement. Postoperative nutritional support and fluid replacement will increase survival. It is very important that when gastric distention disappears after conservative therapy, the doctor should assess carefully whether the gastric wall recovery is under way by using effective methods of examination.- - - - - - - - - - ranking = 0.5keywords = stomach (Clic here for more details about this article) |
7/61. Unusual presentation of gastric duplication cyst in a neonate with pneumoperitoneum and vertebral anomalies.An unusual case of communicating, tubular gastric duplication (GD) of the greater curvature of the stomach presenting with pneumoperitoneum is described. The pneumoperitoneum resulted due to simultaneous mechanical rupture of stomach and its duplication cyst due to birth trauma and vigorous post delivery resuscitation. No case of this kind has been reported earlier in English literature, though instances of ulcerative perforation of neonatal stomach and GD are known. There was radiographic evidence of multiple thoracic vertebral anomalies, again a rare occurrence with GD cyst. Further, a diagnostic dilemma was faced in this patient as the presence of radiographic sign of "gastric bubble" on plain radiographs in this patient suggested the source of free intraperitoneal air to be extragastric and the diagnosis could be made only at surgery. The authors have reviewed the pertinent literature on neonatal gastric perforation and GD cysts and uphold "split notochord" theory as etiology for GD in this patient.- - - - - - - - - - ranking = 1.5004808843909keywords = stomach, ulcer (Clic here for more details about this article) |
8/61. Gastro-esophageal barotrauma in diving: similarities with mallory-weiss syndrome.mallory-weiss syndrome (MWS) is a well-defined entity in clinical medicine. However, the development of such a syndrome as a result of overpressure barotrauma of the stomach after repeated shallow-water scuba dives is rare. Also rare is the delayed onset of the MWS, approximately 20 hours after the dives. The causes of development of MWS in connection with scuba diving are discussed. The main causes seem to be the repeated changes of gas volume in the stomach with subsequent pressure forces toward the cardia in the course of repeated dives. The possibility of serious diving accident due to overpressure barotrauma of gastro-intestinal system is also pointed out.- - - - - - - - - - ranking = 1keywords = stomach (Clic here for more details about this article) |
9/61. Gastric perforation in a newborn.Gastric perforation in neonates is an uncommon condition. In most cases, it is attributed to peptic ulceration and/or hemorrhagic gastritis. The high mortality rate in such patients can be improved by early diagnosis and prompt resuscitation, followed by surgery. We report a full-term female newborn, who developed a gastric perforation in the first day of life. The possible aetiology and the perioperative management are discussed.- - - - - - - - - - ranking = 0.00048088439087433keywords = ulcer (Clic here for more details about this article) |
10/61. Sudden unexpected death due to rupture of the stomach.We report a case of sudden unexpected death due to rupture of the stomach. A 49-year-old man was found dead in a public lavatory. autopsy findings revealed two rupture wounds measuring 14 cm and 6 cm located in the fundus of stomach at the side of the greater curvature despite of any superficial injury. The deceased had an ulcer in the lesser curvature of stomach, and dilation in this area was expected to be impaired. Under this condition, excessive over-eating resulting in over-extension of the stomach wall at the greater curvature was speculated to have caused stomach rupture.- - - - - - - - - - ranking = 4.5004808843909keywords = stomach, ulcer (Clic here for more details about this article) |
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