Michael G. DeGroote School of Medicine (Waterloo Regional Campus), McMaster University, Hamilton, Canada.
Department of Medicine, Dalhousie University, Halifax, Canada.
J Med Case Rep. 2021 Feb 8;15(1):61. doi: 10.1186/s13256-020-02575-7.
Acute gastric dilatation (AGD) leading to gastric necrosis and perforation has been reported to be a rare but fatal complication in young patients with eating disorders, particularly anorexia nervosa.
We report a case of a Canadian female patient presenting with mild abdominal pain, with a history of anorexia nervosa, the binge/purge subtype, who was found to have severe acute gastric dilatation on subsequent computed tomography imaging. Her clinical course was uncomplicated after gastric decompression. The cause of her AGD was thought to be secondary to dysmotility disorder caused by her anorexia nervosa.
Our case report demonstrates the importance of clinical identification of AGD and subsequent diagnosis and management. Because of the urgency to rule out obstruction or perforation through consultation or additional imaging modalities, recognition and correct diagnosis of this condition is necessary for appropriate patient management. In addition, our case report adds to an underreported but important complication of anorexia nervosa.
急性胃扩张(AGD)导致胃坏死和穿孔,在患有饮食失调症的年轻患者中,尤其是神经性厌食症患者中,已被报道为一种罕见但致命的并发症。
我们报告了一例加拿大女性患者,表现为轻度腹痛,有神经性厌食症病史,暴食/清除型,随后的计算机断层扫描成像显示严重的急性胃扩张。她在胃减压后临床病程平稳。AGD 的病因被认为是由于神经性厌食症引起的运动障碍。
我们的病例报告表明了临床识别 AGD 以及随后的诊断和管理的重要性。由于需要通过咨询或其他成像方式紧急排除梗阻或穿孔,因此需要识别和正确诊断这种疾病,以便进行适当的患者管理。此外,我们的病例报告增加了一个报道较少但重要的神经性厌食症并发症。