Han You Jin, Roy Susmit, Siau Ashley Maria Pei Ling, Majid Adeeb
School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Newcastle, NSW, 2308, Australia.
Calvary Mater Hospital, Newcastle, Edith & Platt St, Waratah, Newcastle, NSW, 2298, Australia.
J Eat Disord. 2022 Nov 9;10(1):157. doi: 10.1186/s40337-022-00677-9.
Disordered eating behaviour including binge-eating often results in significant medical conditions, which are at times fatal. It can result in acute gastric dilatation which can lead to ischemic necrosis and stomach rupture. Dyspepsia and bloating are common symptoms following binge eating. Patients commonly use over-the-counter medications like sodium bicarbonate or home remedies for relief. However, in very rare, reported cases, sodium bicarbonate has been attributed to cause acute gastric dilatation and spontaneous gastric rupture instead.
We report two cases of spontaneous gastric rupture following consumption of sodium bicarbonate containing antacids after a large meal, and a review of the literature of similar cases.
A total of 36 cases were identified. Approximately half of the cases (47.2%) were correlated with eating disorders, with higher prevalence in females (69%) and a very high mortality rate (41.6%). Amongst the 36 cases, sodium bicarbonate ingestion was associated with 10 cases. The lesser curvature (36.1%) and anterior wall (33.3%) are the most common sites of rupture. Associated causes include binge-eating, gas release from sodium bicarbonate, gastric content fermentation, proximal and distal outlet obstruction, and muscular atony.
Sudden distension and impaired emptying mechanism of the stomach is necessary for spontaneous gastric rupture to occur. Acute gastric dilatation with perforation requires definitive surgical management. There should be a low threshold of suspicion for patients presenting with severe abdominal pain and abdominal distension following an episode of binge-eating. There is a need for patient education around the use of over-the-counter medications or home remedies.
包括暴饮暴食在内的饮食失调行为常常会导致严重的健康问题，有时甚至会危及生命。它可能导致急性胃扩张，进而引发缺血性坏死和胃破裂。消化不良和腹胀是暴饮暴食后的常见症状。患者通常会使用碳酸氢钠等非处方药物或家庭疗法来缓解症状。然而，在极少数报道的病例中，碳酸氢钠反而被认为是导致急性胃扩张和自发性胃破裂的原因。
我们报告了两例在大餐后服用含碳酸氢钠抗酸剂后发生自发性胃破裂的病例，并对类似病例的文献进行了综述。
共识别出36例病例。大约一半的病例（47.2%）与饮食失调有关，女性患病率较高（69%），死亡率也非常高（41.6%）。在这36例病例中，10例与摄入碳酸氢钠有关。胃小弯（36.1%）和前壁（33.3%）是最常见的破裂部位。相关原因包括暴饮暴食、碳酸氢钠释放气体、胃内容物发酵、近端和远端出口梗阻以及肌肉无力。
自发性胃破裂的发生需要胃突然扩张和排空机制受损。急性胃扩张伴穿孔需要明确的手术治疗。对于暴饮暴食后出现严重腹痛和腹胀的患者，应保持较低的怀疑阈值。有必要对患者进行关于使用非处方药物或家庭疗法的教育。
