A Case of Spontaneous Gastric Rupture in a Preschool-Age Child

Abstract

The patient was a 5-year-old girl with no previous disease, who was taken to her family physician because of abdominal pain and nausea. On the next day, her abdominal symptoms worsened, and her consciousness was disturbed. Therefore, she was brought to our Pediatric Intensive Care Unit (PICU) owing to shock. Imaging studies revealed massive abdominal free air and ascites, and she underwent emergency laparotomy with a diagnosis of gastrointestinal perforation. Intraoperative findings confirmed a large 3-cm-diameter hole in the posterior wall near the greater curvature of the upper body of the stomach. With the diagnosis of gastric rupture, we performed a simple closure and abdominal drainage. Postoperatively, she underwent systemic management in the PICU and was discharged on postoperative day 24. In this patient, no clear cause of gastric rupture was identified from her medical history, intraoperative findings, histopathological findings, and postoperative upper gastrointestinal endoscopy findings. Therefore, the patient was diagnosed with spontaneous gastric rupture. Spontaneous gastric rupture after infancy is extremely rare. In previous reports, most of the patients were preschool-age children without any previous disease, and their symptoms worsened rapidly from the time of onset. Suspicion of this disease, prompt diagnosis, and appropriate treatment would lead to the survival of pediatric patients with spontaneous gastric rupture.