RESUMO
BACKGROUND: Herpes zoster is a common disease that can affect men and women at any age. Sensory neuropathy is the most common complication while motor neuropathy of the abdominal muscles is rare complication appearing in ~ 0.7% of patients. Furthermore, visceral nerve involvement causing gastroparesis is an extremely rare postherpetic complication. We present an extremely rare case of acute gastric dilatation with segmented abdominal paresis as a rare manifestation of herpes zoster infection. CASE PRESENTATION: A 91-year-old Asian man was admitted to hospital with 2-day history of vomiting and left abdominal protrusion. He was previously treated for a rash on the left abdominal wall as herpes zoster infection with oral valaciclovir 2 weeks prior. On physical examination, characteristic herpes zoster rash scars and an ipsilateral abdominal bulge were observed on the left side. Computed tomography revealed no abdominal wall defect, mass, or stenosis. Remarkable distension of the stomach, asymmetrical left flank wall bulge, and a thinner abdominal wall on the left compared with the right side were shown. He was diagnosed as acute gastric dilatation owing to gastroparesis and segmental paresis of the abdominal musculature associated with herpes zoster infection. The patient showed significant improvement in symptoms and abdominal paresis within a month of conservative treatment, including nasogastric tube decompression and mosapride administration. CONCLUSION: Acute gastric dilatation with abdominal paresis is an extremely rare complication of herpes zoster infection, and to date there have been no reports in the literature. It alerts us that, when examining patients with abdominal bulge, we should be conscious of this rare pathology for the optical diagnosis, avoiding unnecessary invasive examination or surgical exploration.
Assuntos
Exantema , Dilatação Gástrica , Gastroparesia , Herpes Zoster , Idoso de 80 Anos ou mais , Humanos , Masculino , Músculos Abdominais , Dilatação Gástrica/etiologia , Dilatação Gástrica/complicações , Gastroparesia/diagnóstico por imagem , Gastroparesia/etiologia , Herpes Zoster/complicações , Herpes Zoster/tratamento farmacológico , Herpes Zoster/diagnóstico , Herpesvirus Humano 3 , Paresia/complicaçõesRESUMO
OBJECTIVE: To report the outcomes and complications associated with prophylactic incisional gastropexy performed in dog breeds at risk for GDV. RESULTS: Seven hundred and sixty-six dogs underwent prophylactic incisional gastropexy of which 61 were electively performed at the time of castration or spay and 705 were adjunctively performed at the time of emergency abdominal surgery. All dogs had short-term follow-up, and 446 dogs (58.2%) had additional follow-up with a median long-term follow-up time of 876 days (range 58-4450). Only 3 dogs (0.4%) had a direct complication associated with the gastropexy site including hemorrhage causing hemoabdomen (2) and infection with partial dehiscence (1). No dogs with long-term follow-up experienced gastric dilatation (GD), gastric dilatation volvulus (GDV), or persistent GI signs following gastropexy. Results of this study found that complications directly associated with prophylactic gastropexy were rare and limited to hemorrhage causing hemoabdomen and infection with partial dehiscence. Transient postoperative GI signs may occur. Gastropexy malpositioning and bowel entrapment were not encountered. There was no occurrence of GD or GDV.
Assuntos
Doenças do Cão , Dilatação Gástrica , Gastropexia , Volvo Gástrico , Cães , Animais , Dilatação Gástrica/etiologia , Dilatação Gástrica/prevenção & controle , Dilatação Gástrica/cirurgia , Gastropexia/efeitos adversos , Gastropexia/métodos , Gastropexia/veterinária , Doenças do Cão/cirurgia , Volvo Gástrico/etiologia , Volvo Gástrico/cirurgia , Volvo Gástrico/veterinária , HemoperitônioAssuntos
Transtorno da Compulsão Alimentar , Dilatação Gástrica , Síndrome da Artéria Mesentérica Superior , Humanos , Síndrome da Artéria Mesentérica Superior/diagnóstico , Síndrome da Artéria Mesentérica Superior/etiologia , Dilatação Gástrica/diagnóstico , Dilatação Gástrica/etiologia , Dilatação Patológica , Doença Aguda , Artéria Mesentérica SuperiorRESUMO
Hepatic portal vein gas (HPVG) is caused by the influx of gastrointestinal gas into the intrahepatic portal vein as a result of gastrointestinal wall fragility due to ischemia or necrosis. Gastrointestinal tract necrosis is fatal in severe cases. We observed a case of food intake-induced acute gastric dilatation (AGD) in a healthy young male who developed HPVG and underwent conservative treatment. A 25-year-old male presented to our hospital with epigastric pain and nausea the day after excessive food intake. Computed tomography (CT) revealed gas along the intrahepatic portal vein and marked gastric dilatation with large food residue. AGD-induced HPVG was considered. Esophagogastroduodenoscopy (EGD) was not performed at this stage because of the risk of HPVG and AGD exacerbation, and the patient was followed up with intragastric decompression via a nasogastric tube. Food residue and approximately 2 L of liquid without blood were vomited 1 h after the nasogastric tube placement. His symptoms improved after the vomiting episode. An EGD was performed 2 days after undergoing CT. Endoscopic findings revealed extensive erosions and the presence of a whitish coat extending from the fornix to the lower body of the stomach, indicating AGD. HPVG disappeared on the CT scan taken during EGD. Thereafter, symptom relapse and HPVG recurrence were not observed.
Assuntos
Dilatação Gástrica , Veia Porta , Humanos , Masculino , Adulto , Veia Porta/diagnóstico por imagem , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/etiologia , Tomografia Computadorizada por Raios X , NecroseRESUMO
Acute gastric dilation after binge eating may lead to ischaemic necrosis and perforation of the gastric wall. Though rarely seen owing to the rich blood supply of the stomach, its sequelae may be avoided by prompt decompression of the dilated stomach. We present such a case heretofore rarely reported from India.
Assuntos
Transtorno da Compulsão Alimentar , Dilatação Gástrica , Humanos , Dilatação Gástrica/etiologia , Dilatação Gástrica/complicações , Transtorno da Compulsão Alimentar/complicações , Estômago/diagnóstico por imagem , ÍndiaAssuntos
Traumatismos Abdominais , Dilatação Gástrica , Gastropatias , Síndrome da Artéria Mesentérica Superior , Humanos , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/etiologia , Síndrome da Artéria Mesentérica Superior/complicações , Síndrome da Artéria Mesentérica Superior/diagnóstico por imagem , Necrose/etiologia , Necrose/cirurgiaRESUMO
We have written a "letter to Editor" about a case of gastric dilatation caused by a symptomatic gastric duplication cyst with ectopic pancreas ingrowth, in a 13 years old boy. The Endoscopy Ultra Sound characterized the lesion and permitted the aspiration of the internal liquid. The patient underwent to laparoscopic excision of the mass and the histology revealed a gastric duplication cyst with ectopic pancreas ingrowth.
Assuntos
Cistos , Dilatação Gástrica , Laparoscopia , Masculino , Humanos , Adolescente , Cistos/complicações , Cistos/diagnóstico por imagem , Cistos/cirurgia , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/etiologia , Dilatação Gástrica/cirurgia , Endossonografia , PâncreasAssuntos
Humanos , Masculino , Adulto , Dilatação Gástrica/etiologia , Transtorno da Compulsão Alimentar/complicações , Isquemia/etiologia , Veia Porta/diagnóstico por imagem , Dilatação Gástrica/patologia , Dilatação Gástrica/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Doença AgudaRESUMO
Acute gastric dilatation is a rare and potentially life-threatening condition that may occur in patients suffering from anorexia nervosa after ingesting large amounts of food within a short period. Frequently, this condition is considered a surgical emergency due to subsequent occurrence of complications such as gastric necrosis or perforation.Here we report a case of a young female patient (23 years) with anorexia nervosa who presented with severe abdominal pain, nausea, and inability to vomit after a period of binge eating. Abdominal computed tomography revealed an extremely dilated stomach measuring 39.0 cm × 18.0 cm in size. Initial nasal decompression therapy using gastric tubes had failed. Due to the absence of complications, it was decided to treat her solely by endoscopic means under mechanical ventilation. After undergoing multiple overtube-assisted esophagogastroduodenoscopies (EGDs), she fully recovered eventually.This case demonstrates that interventional endoscopic treatment of a patient with uncomplicated acute gastric dilatation is feasible and safe, at least under general anesthesia. Hence, this option should be considered when sole gastric tube suction fails, and there is no indication of complications such as peritonitis, sepsis, perforation, or gastric ischemia. A more invasive and aggressive surgical procedure may be avoided in selected cases, and the length of hospital stay may be shortened.
Assuntos
Anorexia Nervosa , Transtorno da Compulsão Alimentar , Bulimia , Dilatação Gástrica , Doença Aguda , Anorexia Nervosa/complicações , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/terapia , Transtorno da Compulsão Alimentar/complicações , Bulimia/complicações , Feminino , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/etiologia , HumanosAssuntos
Transtorno da Compulsão Alimentar , Dilatação Gástrica , Síndrome da Artéria Mesentérica Superior , Humanos , Adolescente , Síndrome da Artéria Mesentérica Superior/diagnóstico , Síndrome da Artéria Mesentérica Superior/diagnóstico por imagem , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/etiologia , Transtorno da Compulsão Alimentar/complicações , Doença AgudaRESUMO
BACKGROUND: 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. CASE PRESENTATION: 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. CONCLUSION: 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.
Assuntos
Anorexia Nervosa , Dilatação Gástrica , Doença Aguda , Anorexia Nervosa/complicações , Canadá , Feminino , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/etiologia , HumanosRESUMO
A 43-year-old female with a history of anorexia nervosa presented to our hospital with diffuse abdominal pain and distension after a binge eating episode. Vital signs and routine laboratory test results were unremarkable, except for a slightly elevated white blood cell count (14.5 x 109/l). Abdominal radiography and computed tomography (CT) revealed a massively dilated stomach, with a craniocaudal measurement of 37 cm.
Assuntos
Anorexia Nervosa , Bulimia , Dilatação Gástrica , Doença Aguda , Adulto , Anorexia Nervosa/complicações , Feminino , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/etiologia , HumanosRESUMO
The universal definition of myocardial infarction (MI) provides five subtypes of acute myocardial infarction (AMI). We present an interesting case of a type 2 myocardial infarction caused by the dilation of the left thoracic stomach.
Assuntos
Anastomose Cirúrgica/efeitos adversos , Esôfago/cirurgia , Dilatação Gástrica/etiologia , Infarto Miocárdico de Parede Inferior/etiologia , Estômago/cirurgia , Doença Aguda , Idoso , Benzamidas/uso terapêutico , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/tratamento farmacológico , Estenose Coronária/etiologia , Eletrocardiografia , Esofagectomia/métodos , Esôfago/diagnóstico por imagem , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/tratamento farmacológico , Fármacos Gastrointestinais/uso terapêutico , Gastroparesia/diagnóstico por imagem , Gastroparesia/tratamento farmacológico , Gastroparesia/etiologia , Humanos , Infarto Miocárdico de Parede Inferior/diagnóstico , Masculino , Morfolinas/uso terapêutico , Estômago/diagnóstico por imagem , Neoplasias Gástricas/cirurgia , Cavidade Torácica/diagnóstico por imagemRESUMO
A 57-year-old male with a history of chronic pancreatitis related to heavy smoking and alcohol abuse was evaluated in the emergency department due to a 3-day history of epigastric pain and postprandial vomiting. Abdominal computed tomography (CT) was performed and revealed a severe gastric dilation that reached the pelvis. There was a marked concentric mural thickening at the duodenal level and an intramural cysts that caused a narrowing of the light and a retrograde gastric dilation. There were no findings suggestive of chronic pancreatitis. A diagnosis was made of duodenal obstruction due to groove pancreatitis with severe secondary gastric dilatation.
Assuntos
Dilatação Gástrica , Pancreatite Crônica , Duodeno , Dilatação Gástrica/diagnóstico por imagem , Dilatação Gástrica/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatite Crônica/complicações , Pancreatite Crônica/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
Abstract The universal definition of myocardial infarction (MI) provides five subtypes of acute myocardial infarction (AMI). We present an interesting case of a type 2 myocardial infarction caused by the dilation of the left thoracic stomach.
Assuntos
Humanos , Masculino , Idoso , Estômago/cirurgia , Dilatação Gástrica/etiologia , Anastomose Cirúrgica/efeitos adversos , Esôfago/cirurgia , Infarto Miocárdico de Parede Inferior/etiologia , Dilatação Gástrica/tratamento farmacológico , Dilatação Gástrica/diagnóstico por imagem , Benzamidas/uso terapêutico , Fármacos Gastrointestinais/uso terapêutico , Morfolinas/uso terapêutico , Doença Aguda , Esofagectomia/métodos , Gastroparesia/etiologia , Gastroparesia/tratamento farmacológico , Gastroparesia/diagnóstico por imagem , Estenose Coronária/etiologia , Estenose Coronária/tratamento farmacológico , Estenose Coronária/diagnóstico por imagem , Eletrocardiografia , Esôfago/diagnóstico por imagem , Infarto Miocárdico de Parede Inferior/diagnósticoRESUMO
Acute massive gastric dilatation (AMGD) is a rare event which is usually underdiagnosed. It can occur due to multiple etiologies, including medical and surgical, or as a postoperative complication. We report a rare case of AMGD as a result of closed-loop obstruction of the stomach following feeding jejunostomy in a patient with carcinoma oesophagus. A high index of suspicion, early diagnosis and prompt management is the key to the successful treatment. To the best of our knowledge, this is the second case report of a closed-loop obstruction of the stomach leading to AMGD in published literature.