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. 2016 Sep 30:17:694-698.
doi: 10.12659/ajcr.898939.

Spontaneous Gastric Perforation in Two Adolescents

Amaka Akalonu  1 , Mona Yasrebi  2 , Zarela Molle Rios  1
Affiliations

Spontaneous Gastric Perforation in Two Adolescents

Amaka Akalonu et al. Am J Case Rep. .

Abstract

BACKGROUND Spontaneous gastric perforation is a rare clinical disorder. The majority of the available data have been reported in the neonatal age group. There are a few cases of spontaneous gastric perforation in preschool children. To our knowledge, there is no published information on spontaneous gastric perforation in older children and adolescents. CASE REPORT We describe the presentation and clinical course of two adolescent children who presented with spontaneous gastric perforation. Both children presented with acute onset abdominal pain, which progressively worsened. In both cases, the patient were taken urgently to the operating room after imaging studies had shown pneumoperitoneum. In both cases, surgery revealed gastric perforation with no obvious etiology, specifically no -ulcer, inflammation, or other pathology. CONCLUSIONS These two cases highlight the importance of including spontaneous gastric perforation, not just the typical duodenal/gastric ulcer, in the differential of a patient with severe abdominal pain and distension, who has imaging showing pneumoperitoneum.

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Figures

Figure 1.
Figure 1.
Radiographs from Patient A. Abdominal CT scan with intravenous and oral contrast. (A) Axial abdominal CT scan demonstrating intraluminal gastric contrast (white arrow) and free intraperitoneal air (asterisk). (B) Axial abdominal CT scan demonstrating extravasation of oral contrast from the gastric lumen (white arrows) and free intraperitoneal air (asterisk). (C) Sagittal abdominal CT scan demonstrating free intraperitoneal air (asterisk). (D) Coronal abdominal CT scan demonstrating extravasation of oral contrast (white arrows) and free pelvic fluid (star).
Figure 2.
Figure 2.
Radiographs from Patient B. (A) Frontal upright chest radiograph demonstrating air beneath the diaphragms, consistent with free intraperitoneal air (asterisk). (B) Left lateral decubitus radiograph demonstrating air overlying the right hemi-abdomen, consistent with free intraperitoneal air (asterisk).
See this image and copyright information in PMC

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