Gastric Necrosis and Perforation Following Massive Gastric Dilatation in an Adolescent Girl: A Rare Cause of Acute Abdomen

Abstract

Gastric necrosis with perforation is a rare and potentially life-threatening condition in childhood beyond the neonatal period. We report a case of gastric necrosis and perforation of a portion of the great curvature due to a massive gastric dilatation caused by pathological aerophagia in a 13-years-old, mentally impaired adolescent girl. Despite the successful surgical treatment, the patient's condition rapidly deteriorated post-operatively and she died due to the multisystem organ failure and multiple infections. In addition, we surveyed the literature on this rare condition and assessed the preventive actions to reduce this life-treating condition.

Keywords: acute abdomen; gastric dilatation; gastric perforation; necrosis; pathological aerophagia.

Figure 1

A plain abdominal radiograph showing a massive pneumoperitoneum within the abdominal cavity.

Figure 2

(A,B) Intraoperative findings of partial gastric necrosis and perforation (before and after debridement of necrotic tissue).

Figure 3

(A,B) Hematoxylin and Eosin-stained (H&E) sections of the resected stomach revealed the presence of the extensive necrosis affecting the entire gastric wall (B) while the left image (A) shows in part preserved the mucosal surface of the gastric wall (10×).