ABSTRACT
BACKGROUND: Anorexia nervosa may cause several gastro-intestinal complications. CASE DESCRIPTION: A 21-year-old woman presented herself with abdominal pain and vomiting a day after her first binge-eating episode. In her recent history she had lost 40 kg in weight and her BMI was 15 at presentation. Imaging showed gastric distension and ascites in all quadrants, suspicious of a gastric rupture. A blow-out of the stomach was seen during a diagnostic laparotomy, which was treated with a gastric sleeve procedure. Following surgery, the patient was diagnosed with anorexia nervosa of the restrictive type with a first episode of binge-eating. CONCLUSION: Gastric rupture is a rare and unknown complication of anorexia nervosa with a high mortality.
Subject(s)
Anorexia Nervosa , Stomach Rupture , Humans , Female , Anorexia Nervosa/complications , Young Adult , Stomach Rupture/etiology , Stomach Rupture/surgery , Treatment Outcome , Abdominal Pain/etiology , AdultABSTRACT
PURPOSE: The aim of the study was to test the established hypothesis that biopsies of spontaneous gastric perforations should be taken to rule out cancer. METHODS: A prospective observational study was performed. Consecutive patients with spontaneous gastric perforation were included. Biopsies of the edges of the perforation were submitted for histological evaluation. The epithelial type as well as the nature of the pathology were evaluated. RESULTS: Sixty-eight patients were included. Eight (12%) biopsies revealed duodenal origin. Sixty (88%) biopsies revealed gastric mucosa of which 33 (48%) could be specifically typed. All biopsies revealed benign ulceration. No malignancies were detected in these biopsies or on subsequent gastroscopic follow up. CONCLUSION: This study suggests that routine intraoperative biopsy of gastric perforation may be questioned. Biopsy is probably better performed endoscopically after recovery.
Subject(s)
Gastric Mucosa , Humans , Male , Female , Middle Aged , Prospective Studies , Aged , Biopsy/adverse effects , Adult , Gastric Mucosa/pathology , Aged, 80 and over , Gastroscopy , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Stomach Rupture/surgery , Stomach Rupture/pathology , Stomach Rupture/etiologySubject(s)
Stomach Rupture , Child , Humans , Cysts/complications , Cysts/etiology , Rupture, Spontaneous , Stomach Rupture/etiologyABSTRACT
Introdução: A ruptura gástrica é uma complicação incomum da distensão e aumento da pressão intragástrica, podendo ter diversas etiologias, não sendo necessariamente relacionada a lesões pré-existentes. O quadro clínico pode ser inespecífico, sendo necessário exame de imagem complementar. Objetivos: Identificar as características fisiopatológicas da lesão gástrica por barotrauma, bem como discutir acerca dos diagnósticos diferencias e prognóstico desta condição. Método: Relato de caso realizado através de revisão de prontuário e exames de um paciente com rotura gástrica por barotrauma. Relato de caso: Paciente de 84 anos, com quadro clínico compatível com rotura gástrica por barotrauma após intubação esofágica inadvertida, cujos exames admissionais demonstravam a presença de importante pneumoperitônio. Foi submetido a tratamento cirúrgico, com rafia primária de lesão de 5 cm em parede gástrica, seguido de encaminhamento para UTI. Conclusão: A redução da incidência de lesões iatrogênicas associadas a ventilação mecânica faz-se necessária. Os médicos devem ser treinados corretamente para realização do procedimento, como também para suspeitarem de antemão das complicações particularmente em pacientes com intubação difícil.(AU)
Introduction: Gastric rupture is an uncommon complication of distension and increased intragastric pressure, and may have several etiologies, not necessarily related to pre-existing lesions. The clinical picture may be nonspecific, requiring complementary imaging. Objectives: To identify the pathophysiological characteristics of the gastric lesion by barotrauma, as well as to discuss the differential diagnoses and prognosis of this condition. Method: Case report performed through medical record review and examination of a patient with gastric rupture by barotrauma. Case Report: Patient of 84 years, with clinical picture compatible with gastric rupture by barotrauma after inadvertent esophageal intubation, whose admissional exams demonstrated the presence of important pneumoperitoneum. He was submitted to surgical treatment, with primary raphy of lesion of 5 cm in the gastric wall, followed by referral to ICU. Conclusion: The reduction of incidence of iatrogenic lesions associated with mechanical ventilation is necessary. Physicians should be properly trained to perform the procedure, as well as to suspect in advance of complications - particularly in patients with difficult intubation.(AU)
Introducción: La rotura gástrica es una complicación infrecuente de distensión y aumento de la presión intragástrica, pudiendo tener diferentes etiologías, no necesariamente relacionadas con lesiones preexistentes. El cuadro clínico puede ser inespecífico, requiriendo un examen de imagen complementario. Objetivos: Identificar las características fisiopatológicas de la lesión gástrica por barotrauma, así como discutir los diferentes diagnósticos y pronósticos de esta patología. Método: Reporte de caso realizado mediante la revisión de historias clínicas y exámenes de un paciente con ruptura gástrica por barotrauma. Caso clínico: Paciente de 84 años con cuadro clínico compatible con rotura gástrica por barotrauma tras intubación esofágica inadvertida, cuyos exámenes de ingreso mostraron la presencia de un neumoperitoneo importante. Se sometió a tratamiento quirúrgico, con rafia primaria de una lesión de 5 cm en la pared gástrica, seguida de derivación a UCI. Conclusíon: Es necesario reducir la incidencia de lesiones iatrogénicas asociadas con la ventilación mecánica. Los médicos deben estar debidamente capacitados para realizar el procedimiento, así como para sospechar complicaciones con anticipación, particularmente en pacientes con intubación difícil.(AU)
Subject(s)
Humans , Aged, 80 and over , Stomach Rupture , Barotrauma , Intubation, GastrointestinalABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Gastric Balloon/adverse effects , Stomach Rupture/etiology , Gastric Emptying , Gastric Fundus/diagnostic imaging , Stomach Rupture/diagnostic imaging , Stomach Rupture/surgery , Abdominal Pain/etiology , Vomiting/complications , Gastric Fundus/injuries , Gastric Fundus/surgery , Abdominal Cavity/surgery , LaparotomyABSTRACT
An 11-year (2007-2018) survey of epidemiological, clinical and pathological findings of horses with primary gastric rupture (PGR) was conducted. Twenty horses presented PGR, nine (45%) horses were clinically evaluated, eleven (55%) were sent dead, and all animals were necropsied. PGR contributed to a prevalence of 0.31% (9/2,868) of all equid attendances, 1.83% (9/491) of colic cases, and 4.1% (20/487) of all equid necropsies. Highly fermentable feed (n=7), gastric impaction (n=4), and perforating gastric ulcer (n=1) were the main causes of PGR; whilst eight horses presented idiopathic gastric rupture. Clinically evaluated horses were tachycardic, tachypneic, febrile, dehydrated, with increased abdominal tension, abnormal mucous membranes and reduced to absent intestinal borborygmi. Improper dietary management, such as the ingestion of low-quality roughage and highly fermentable feedstuffs were detected as the main factors associated with PGR in Midwestern Brazil. It is important to raise awareness in horse owners about proper feed management to minimize PGR.(AU)
Foi realizado um levantamento de 11 anos (2007-2018) dos achados epidemiológicos, clínicos e patológicos de equinos com ruptura gástrica primária (RGP). Vinte equinos apresentaram RGP, dos quais nove (45%) foram avaliados clinicamente e 11 (55%) foram enviados mortos, sendo todos os animais necropsiados. A RGP contribuiu com prevalência de 0,31% de todos os atendimentos de equídeos (9/2.868), 1,83% (9/491) dos casos de cólica, e 4,1% (20/487) das necropsias em equídeos. Alimentos altamente fermentáveis (n=7), compactação gástrica (n=4) e perfuração de úlcera gástrica (n=1) foram as principais causas de RGP, enquanto oito equinos tiveram ruptura gástrica idiopática. Os equinos avaliados clinicamente apresentaram-se taquicárdicos, taquipneicos, febris, desidratados, com mucosas anormais, aumento da tensão abdominal e motilidade intestinal reduzida. O manejo inadequado da dieta, como a ingestão de forragens de baixa qualidade e alimentos altamente fermentáveis, foi o principal fator de risco associado à RGP no Centro-Oeste do Brasil. É importante aumentar a conscientização dos proprietários de equinos sobre o manejo alimentar adequado para minimizar a RGP.(AU)
Subject(s)
Animals , Stomach Rupture/veterinary , Stomach Ulcer/veterinary , Horses/metabolism , Peritonitis/veterinary , Stomach Diseases/veterinary , Dietary Fiber , Abdomen, Acute/veterinaryABSTRACT
La esofagitis enfisematosa es una entidad extremadamente infrecuente sin prácticamente ningún caso descrito en la literatura. Presentamos el caso de una paciente con esofagitis y gastritis enfisematosa con afectación de toda la pared del esófago y el estómago al diagnóstico. Fue intervenida quirúrgicamente por perforación gástrica en dos ocasiones, realizándose cierre primario en ambas con evolución posterior favorable. Pese a la gran extensión de la esófago-gastritis enfisematosa al diagnóstico y la presencia de una perforación gástrica, es seguro realizar un manejo semejante a la gastritis enfisematosa siendo lo más conservadores posibles en caso de precisar cirugía
Emphysematous esophagitis is an extremely rare disease and there are very few previous reports in the literature. We report a case of emphysematous esophagitis and gastritis with complete affectation of the gastric and esophageal wall at diagnosis. Two surgical interventions were performed due to gastric perforation that was treated in both cases with primary closure. The post-operative recovery was satisfactory. Despite the large emphysematous esophago-gastritis affectation at diagnosis and the presence of gastric perforation, it is safe to perform the same management principles as with emphysematous gastritis. This should be as conservative as possible in case a surgical procedure is required
Subject(s)
Humans , Female , Middle Aged , Esophagitis/complications , Emphysema/complications , Stomach Rupture/complications , Gastritis/pathology , Tomography, X-Ray Computed/methods , Esophagitis/diagnostic imaging , Emphysema/diagnostic imaging , Stomach Rupture/diagnostic imaging , Laparoscopy/methodsABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Device Removal/adverse effects , Gastric Mucosa/injuries , Stomach Rupture/etiology , Wound Closure Techniques , Foreign-Body Migration/diagnostic imagingABSTRACT
No disponible
Subject(s)
Humans , Male , Middle Aged , Foreign Bodies/complications , Pancreas/injuries , Stomach Rupture/diagnostic imaging , Tomography, Spiral Computed/methods , Gastroscopy/methodsABSTRACT
No disponible
Subject(s)
Humans , Gastric Balloon/adverse effects , Fundoplication/methods , Stomach Rupture/etiology , Gastric Balloon , Gastroscopy , Obesity, Morbid/surgeryABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Bronchoscopy/adverse effects , Oxygen Inhalation Therapy/instrumentation , Cannula , Bronchoalveolar Lavage/instrumentation , Adenocarcinoma, Bronchiolo-Alveolar/surgery , Stomach Rupture/surgery , Radiography, Thoracic , Abdominal Pain/etiology , Pneumoperitoneum/diagnostic imaging , Pneumoperitoneum/pathology , Laparotomy/methodsABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Gastric Balloon/adverse effects , Stomach Rupture/epidemiology , Fundoplication/adverse effects , Obesity, Morbid/surgery , Postoperative Complications/diagnosis , Obesity/complications , Gastroesophageal Reflux/surgery , Gastric BalloonSubject(s)
Humans , Male , Pancreatitis/complications , Stomach Rupture/etiology , Pancreatitis/surgery , Pancreatitis/diagnostic imaging , Stomach Rupture/surgery , Stomach Rupture/diagnostic imaging , Severity of Illness Index , Tomography, X-Ray Computed , Abdominal Pain/diagnostic imaging , Hematemesis/etiology , Acute DiseaseABSTRACT
Gastric rupture after cardiopulmonary resuscitation (CPR) is a rare complication. In most cases, it is associated with bystander-provided CPR, bag-mask ventilation, and difficult airway management. To the best of our knowledge, there has been only one previous case report in the literature regarding gastric rupture after CPR via supraglottic airway. We present a case of a gastroesophageal junction rupture secondary to CPR with supraglottic airway. Healthcare providers should consider that gastric rupture can be a complication from performing CPR.
Subject(s)
Humans , Airway Management , Cardiopulmonary Resuscitation , Esophagogastric Junction , Health Personnel , Laryngeal Masks , Pneumoperitoneum , Rupture , Stomach Rupture , VentilationABSTRACT
Equine colic is an important and common cause of disease and death in horses. Gastric rupture has been extensively described in the literature, and is known to affect expressive numbers of horses. Gastric dilatation, which precedes rupture, may be observed when the animal consumes large amounts of recently harvested grass or drinks water too fast, though diagnosis criteria also include infestation with Gastherophilus and the presence of ileus and distal intestinal obstructions. The objective of the present study was to determine the resistance to rupture of the equine stomach to air (mm Hg) and water (L) injection. Forty stomachs of young horses (20 geldings and 20 mares) with no defined breed were analyzed. Total organ length (cm), weight (g), greater curved length (cm), lesser curved length (cm) and height (cm) were measured, with no statistical difference between males and females (p > .05). However, stomachs of horses were larger than those of mares and therefore presented higher volumetric capacity (p<0.05). No difference between males and females was observed in the pressure assay (93mmg Hg). Rupture occurred along the greater curvature (99%) and on the visceral (80%) and diaphragmatic (20%) surfaces, across all layers of the gastric wall. Although the equine stomach is relatively small, the organ is considerably resistant to rupture, whether by injection of air or liquid. Horses and mares exhibit similar resistance values, although the stomach of females has smaller volumetric capacity.(AU)
A cólica é um dos problemas mais comuns na clínica de equinos sendo responsável por grande número de mortes. A ruptura gástrica tem sido amplamente descrita na literatura e acomete número expressivo de animais. A dilatação gástrica, que antecede a ruptura, pode advir do consumo excessivo de capim recém-cortado, ingestão rápida de água, infestação por Gastherophilus, ocorrência de íleo paralítico e obstruções intestinais distais. A ruptura gástrica tem sido amplamente descrita na literatura e acomete um número expressivo de animais. Este estudo objetivou determinar a resistência à ruptura do estômago equino mediante a insuflação de ar atmosférico (mmHg) e do preenchimento com água (L). Foram utilizados 40 estômagos de equinos adultos jovens (20 machos castrados e 20 fêmeas) sem raça definida. Medidas relativas ao comprimento total do órgão (cm), peso do órgão (g), curvatura maior (cm), curvatura menor (cm) e altura (cm) foram aferidas e não diferiram entre machos e fêmeas (p>0,05). No entanto, os estômagos dos machos apresentaram medidas superiores as das fêmeas e por assim serem, comportaram um maior volume de água (p<0,05). No teste de resistência mediante insuflação de ar atmosférico não houve diferença entre machos e fêmeas (93mmHg). Os rompimentos ocorreram ao longo da curvatura maior (99%) nas faces visceral (80%) e diafragmática (20%) e abrangeram todas as camadas da parede gástrica. Apesar de ser um órgão relativamente pequeno, o estômago dos equinos apresenta considerável resistência à ruptura, seja por líquido ou por ar atmosférico. Machos e fêmeas possuem resistência gástrica semelhante, embora o estômago das fêmeas equinas comporte um menor volume.(AU)
Subject(s)
Animals , Gastric Dilatation/veterinary , Horses , Stomach Rupture/diagnosis , Stomach Rupture/physiopathology , Stomach Rupture/veterinary , Tensile Strength , Stomach/pathologyABSTRACT
No disponible
Subject(s)
Humans , Female , Middle Aged , Heart Arrest/therapy , Remote Consultation , Cardiopulmonary Resuscitation/adverse effects , Stomach Rupture/etiology , Risk FactorsABSTRACT
PURPOSE: In this study, we aimed to review the clinical presentation of preterm infants with gastrointestinal perforations and compare the clinical features of gastric perforation with other intestinal perforations. METHODS: The medical records of preterm neonates with pneumoperitoneum, admitted to the neonatal intensive care unit (NICU) between January 1994 and December 2013, were retrospectively reviewed. RESULTS: Twenty-one preterm infants underwent exploratory laparotomy to investigate the cause of the pneumoperitoneum. The sample consisted of five patients (23.8%) with gastric perforation and 16 patients (76.2%) with intestinal perforation. No statistical differences were found in the birth history and other perinatal factors between the two groups. Underlying necrotizing enterocolitis, bilious vomiting, and paralytic ileus preceding the perforation were statistically more common in the intestinal perforation group. All preterm infants with gastric perforation survived to discharge; however, six preterm infants with intestinal perforation expired during treatment in the NICU. In the gastric perforation group, sudden pneumoperitoneum was the most common finding, and the mean age at diagnosis was 4.4+/-1.7 days of life. The location and size of the perforations varied, and simple closure or partial gastrectomy was performed. CONCLUSION: Patients with gastric perforation did not have a common clinical finding preceding the perforation diagnosis. Although mortality in previous studies was high, all patients survived to discharge in the present study. When a preterm infant aged less than one week presents with sudden abdominal distension and pneumoperitoneum, gastric perforation should first be excluded. Prompt exploratory laparotomy will increase the survival rates of these infants.
Subject(s)
Humans , Infant , Infant, Newborn , Diagnosis , Enterocolitis, Necrotizing , Gastrectomy , Infant, Premature , Intensive Care, Neonatal , Intestinal Perforation , Intestinal Pseudo-Obstruction , Laparotomy , Medical Records , Mortality , Pneumoperitoneum , Reproductive History , Retrospective Studies , Stomach Rupture , Survival Rate , VomitingABSTRACT
Surgeons occasionally encounter a patient with a gastric cancer invading an adjacent organ, such as the pancreas, liver, or transverse colon. Although there is no established guideline for treatment of invasive gastric cancer, combined resection with radical gastrectomy is conventionally performed for curative purposes. We recently treated a patient with a large gastric cancer invading the abdominal wall, which was initially diagnosed as a simple abdominal wall abscess. Computed tomography showed that an abscess had formed adjacent to the greater curvature of the stomach. During surgery, we made an incision on the abdominal wall to drain the abscess, and performed curative total gastrectomy with partial excision of the involved abdominal wall. The patient received intensive treatment and wound management postoperatively with no surgery-related adverse events. However, the patient could not receive adjuvant chemotherapy and expired on the 82nd postoperative day.
Subject(s)
Humans , Abdominal Wall , Abscess , Chemotherapy, Adjuvant , Colon, Transverse , Gastrectomy , Liver , Neoplasm Invasiveness , Pancreas , Stomach , Stomach Neoplasms , Stomach Rupture , Surgeons , Wounds and InjuriesABSTRACT
No disponible
Subject(s)
Humans , Mediastinal Emphysema/etiology , Stomach Volvulus/complications , Hernia, Hiatal/complications , Stomach Rupture/etiology , Risk FactorsABSTRACT
Accidental or suicidal ingestion of acid usually affects the lower oesophagus and stomach. Harpic is a commonly used toilet cleaning solution and contains hydrochloric acid as the active ingredient, whose ingestion can affect both the stomach and intestines in the form of gangrene and perforation. Symptomatic treatment aims at dilution of the ingested corrosive and specific management involves correcting metabolic imbalances, coagulopathy and emergency surgical intervention for severe injury and late sequelae. We present the case of a 20 year old male with suicidal ingestion of Harpic, who presented with severe abdominal pain and signs of generalised peritonitis. He underwent an emergency laparotomy and was found to have only the gastric fundus to be gangrenous with total sparing of rest of the stomach and intestines, which required only a wedge resection of the stomach. The patient made a good postoperative recovery and is free from complications at the end of one year of follow-up
No disponible