Abstract
Anorexia nervosa is well known of its fatal complications with severe emaciation. We report a case of anorexia nervosa with multiple organ failure, disseminated intravascular coagulation syndrome and mediastinal emphysema. A 20-year-old woman, who had emaciated from 60kg to 36kg for 9 months, came to our Saitama Chuo Hospital. Further she lost her body weight of 5kg during two weeks and she was in coma on admission. Chest CT showed mediastinal emphysema and subcutaneous emphysema. We found severe liver dysfunction and disseminated intravascular coagulation syndrome on laboratory examinations. Tarry stool was found on 2nd day. We diagnosed her as duodenal ulcer by gastrointestinal endoscopy. On 16th day she had abdominal pain and her serum amylase was markedly elevated. Abdomen CT revealed that her pancreas was swelling with the diagnosis of acute pancreatitis. We started intravenous hyperalimentation, gabexate mesilate (FOY^[○!R]), platelet transfusions and H_2-blocker and her general condition was improved. She started eating and had weight gain. She was discharged on 141th day when she gained her body weight up to 37.2kg. We think that all complications of this case were induced by severe emaciation and especially weight loss which progressed rapidly.
