Cases reported "Stomach Rupture"

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1/30. Neonatal gastric volvulus.

    Three infants with acute gastric volvulus occurring during the first week of life are presented, bringing the total number of cases reported in the neonatal period to nine. Abdominal radiographs and constrast studies of the upper gastrointestinal tract were nearly identical in all three infants and showed a characteristic pattern that allowed unequivocal preoperative diagnosis. It is essential that the radiologist recognize the radiographic features of acute gastric volvulus, since prompt operative intervention is mandatory to prevent late complications, which include gastric perforation and death.
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2/30. 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.
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3/30. Intrathoracic herniation and perforation 18 years after open Nissen fundoplication.

    Nissen fundoplication is the most commonly performed surgical procedure in the management of gastroesophageal reflux disease. Esophageal and gastric perforations most commonly occur in the perioperative period and carry significant morbidity. We describe a unique case of intrathoracic gastric wrap perforation and its suspected pathophysiology almost two decades after the original procedure.
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4/30. 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.
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5/30. A spontaneously ruptured gastric stromal tumor presenting as generalized peritonitis: report of a case.

    Among the diverse clinical presentations of gastrointestinal stromal tumor (GIST), spontaneous rupture with peritonitis is extremely rare. We report herein the unusual case of a 75-year-old man found to have a spontaneously ruptured gastric stromal tumor after presenting with generalized peritonitis. The patient was brought to the emergency department of our hospital by ambulance, with generalized severe abdominal pain. On examination, his abdomen was extensively distended with generalized severe rebound tenderness. Abdominal computed tomography scan showed a giant mass arising from the anterior gastric wall with an irregular internal low-density area and a small amount of ascites. An emergency laparotomy revealed a ruptured gastric tumor with dissemination of its necrotic tissue throughout the peritoneal cavity. The tumor was excised together with normal gastric tissue around its base. The tumor, which was 15 x 11 x 4.4cm in size, had a coarse laceration over its well-capsulated smooth serosal surface with massive necrosis and clotted blood inside. Immunohistochemical examination revealed positive reactivity to C-kit protein, which was consistent with the newly introduced diagnostic criteria of GIST. The patient had an uneventful postoperative course and remains well.
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6/30. 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.
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7/30. 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.
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8/30. 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.
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9/30. Gastric rupture associated with pregnancy.

    BACKGROUND: Spontaneous gastric rupture during pregnancy is rare. CASE: A young primigravida delivered a 34-week stillborn infant. Shortly after delivery, she developed signs of hypovolemic shock. Ultrasound examination showed a large amount of free intra-abdominal fluid. At laparotomy, gastric rupture was encountered and repaired. Congenital eventration of the left hemidiaphragm was also noted. After a complicated postoperative course, the patient recovered and has done well. CONCLUSION: Rapid surgical intervention for gastric rupture associated with pregnancy is necessary for maternal survival.
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10/30. rupture of the lesser gastric curvature after a heimlich maneuver.

    BACKGROUND: We present a case of lesser gastric curvature injury after a heimlich maneuver due to obstruction of the breathing tract that was repaired by laparoscopic surgery. methods: A patient with perforation of the lesser gastric curvature as a result of closed abdominal traumatism was operated on using the laparoscopic approach with the use of four trocars as work openings. With this technique, the diagnosis was confirmed, the injury repaired, and the abdominal cavity washed. RESULTS: The postoperative period was favorable and the patient was released from the hospital on day 7 without any complications. CONCLUSIONS: Laparoscopic surgery can be technically reproduced in the treatment of gastric injury as a result of closed abdominal traumatism.
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