Gastric rupture after overeating

Abstract

A 22-year-old female with a past medical history of acute gastric dilation after overeating, complained of abdominal pain and nausea after an episode of bulimia. She was diagnosed as having acute gastric dilation. Despite nasogastric decompression, her clinical condition deteriorated, and she developed shock. On CT scan of the abdomen, ascites and free air were noted. An diagnostic tap of the ascites yielded a dirty effusion. Under the diagnosis of gastric rupture, emergency surgery was done. Almost all of the stomach was necrotic, and it was full of ingested food ; due to gastric rupture necrotic tissue was found in the peritoneal cavity. The spleen was also necrotic. A total gastrectomy with splenectomy was performed.
During and after operation, the patient remained in shock. She developed multiple organ failure and DIC. Despite all efforts, she died 26 hours after surgery.