贪食症患者暴饮暴食后出现胃坏死：全胃切除术后饮食失调的康复情况。
Gastric Necrosis After Binge Eating in Bulimia: Recovery From Eating Disorder After Total Gastrectomy.
作者信息
Achamrah Najate, Grigioni Sébastien, Coëffier Moïse, Ainseba Nadjib, Déchelotte Pierre
机构信息
Nutrition Department, Rouen University Hospital Center, Rouen, France.
Normandie Univ, UNIROUEN, INSERM UMR 1073, Nutrition, Inflammation et dysfonction de l'axe Intestin-Cerveau, IRIB, Rouen, France.
出版信息
Front Psychiatry. 2020 Jul 31;11:741. doi: 10.3389/fpsyt.2020.00741. eCollection 2020.
BACKGROUND
Gastric necrosis following acute gastric dilatation is rare but more common in females with eating disorders, such as anorexia nervosa or bulimia, during which patients often alternate restriction and binge eating behaviors.
CASE PRESENTATION
A 37-year old female patient with a history of 15 years of bulimia nervosa was admitted to the emergency department 24 h after binge eating. Abdominal Computed Tomography imaging showed major gastric distension reaching the pelvis and compressing the digestive organs. Total gastrectomy was required because of gastric necrosis. The patient reported significant reduction in bulimic symptoms after gastrectomy.
CONCLUSION
We discuss here the possible mechanisms underlying this recovery, including changes in gut-derived factors that could mediate eating behavior changes.
背景
急性胃扩张后发生胃坏死较为罕见，但在患有饮食失调症（如神经性厌食症或暴食症）的女性中更为常见，在此期间患者常交替出现节食和暴饮暴食行为。
病例报告
一名有15年神经性贪食症病史的37岁女性患者，在暴饮暴食24小时后被送往急诊科。腹部计算机断层扫描成像显示胃严重扩张至盆腔并压迫消化器官。由于胃坏死，需要进行全胃切除术。患者报告称全胃切除术后贪食症状明显减轻。
结论
我们在此讨论这种恢复可能的潜在机制，包括可能介导饮食行为改变的肠道衍生因子的变化。
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