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Case Reports
. 2010 Oct;3(4):403-5.
doi: 10.4103/0974-2700.70774.

Acute gastric dilatation in a patient with anorexia nervosa binge/purge subtype

Ailis M Tweed-Kent  1 , Peter J Fagenholz, Hasan B Alam
Affiliations
Case Reports

Acute gastric dilatation in a patient with anorexia nervosa binge/purge subtype

Ailis M Tweed-Kent et al. J Emerg Trauma Shock. 2010 Oct.

Abstract

Acute gastric dilatation is a rare complication of anorexia nervosa binge/purge subtype that results from gastrointestinal abnormalities, including decreased gastric motility and delayed gastric emptying. Early diagnosis and intervention is critical since delay may result in gastric necrosis, perforation, shock, and death. We report a 26-year-old female with anorexia nervosa binge/purge subtype, who presented with abdominal pain and nausea after a binge episode. Abdominal radiography and computed tomography showed a grossly dilated stomach measuring 32 cm × 17.9 cm consistent with acute gastric dilatation. She underwent exploratory laparotomy with gastrotomy and gastric decompression, and recovered uneventfully. Initially, the patient denied the binge episode, as many patients with eating disorders do, but later revealed an extensive history of anorexia nervosa binge/purge subtype. This case stresses the importance of obtaining a thorough history of eating disorders and maintaining a high index of suspicion for acute gastric dilatation in young women who present with abdominal pain and distention.

Keywords: Acute gastric dilatation; anorexia; binge/purge; denial; eating disorder; gastric dysmotility.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Abdominal radiograph showing a massively enlarged stomach, which occupies the entire abdominal cavity and displaces the transverse colon into the pelvis
Figure 2
Figure 2
Coronal image of an abdominal CT scan, which reveal a distended stomach containing air and circular radiodense material, which was later revealed to be pasta
See this image and copyright information in PMC

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