Gastric Rupture Secondary to a Heimlich Maneuver: A Case Report.

A gastric rupture resulting from abdominal trauma is a rare occurrence with a frequency of less than 2% of blunt abdominal injuries. Furthermore, gastric perforation secondary to the Heimlich maneuver is even rarer, with only a handful of cases reported in the literature. Here, we present a case of isolated gastric rupture following a successful Heimlich maneuver. Laparotomy revealed a large perforation along the lesser curvature of the stomach. The perforation was repaired by primary closure and reinforced with omental patching.

Gastric rupture caused by intragastric perforation of splenic artery aneurysm: a case report and literature review.

BACKGROUND: The rupture of splenic artery pseudoaneurysm (SAP) is life-threatening disease, often caused by trauma and pancreatitis. SAPs often rupture into the abdominal cavity and rarely into the stomach. CASE PRESENTATION: A 70-year-old male with no previous medical history was transported to our emergency center with transient loss of consciousness and tarry stools. After admission, the patient become hemodynamically unstable and his upper abdomen became markedly distended. Contrast-enhanced computed tomography performed on admission showed the presence of a splenic artery aneurysm (SAP) at the bottom of a gastric ulcer. Based on the clinical picture and evidence on explorative tests, we established a preliminary diagnosis of ruptured SAP bleeding into the stomach and performed emergency laparotomy. Intraoperative findings revealed the presence of a large intra-abdominal hematoma that had ruptured into the stomach. When we performed gastrotomy at the anterior wall of the stomach from the ruptured area, we found pulsatile bleeding from the exposed SAP; therefore, the SAP was ligated from inside of the stomach, with gauze packing into the ulcer. We temporarily closed the stomach wall and performed open abdomen management, as a damage control surgery (DCS) approach. On the third day of admission, total gastrectomy and splenectomy were performed, and reconstruction surgery was performed the next day. Histopathological studies of the stomach samples indicated the presence of moderately differentiated tubular adenocarcinoma. Since no malignant cells were found at the rupture site, we concluded that the gastric rupture was caused by increased internal pressure due to the intra-abdominal hematoma. CONCLUSIONS: We successfully treated a patient with intragastric rupture of the SAP that was caused by gastric cancer invasion, accompanied by gastric rupture, by performing DCS. When treating gastric bleeding, such rare causes must be considered and appropriate diagnostic and therapeutic strategies should be designed according to the cause of bleeding.

A Case of Gastric Perforation Caused by Excessive Insufflation during Upper Gastrointestinal Endoscopy: Nonoperative Management.

Introduction: Upper gastrointestinal endoscopy is used to diagnose and treat upper gastrointestinal diseases, but it can also cause complications, including perforation. Perforation is a serious complication, so it is important to be aware of the risk factors in advance and to take precautions to prevent it. Case Presentation: We report a case of gastric perforation caused by excessive insufflation during upper gastrointestinal endoscopy in a 64-year-old man with a history of multiple active gastric ulcers. During the endoscopy, the patient did not cooperate and insufflation was performed for a prolonged period of time. This led to a mucosal laceration and a hole suspected to be a perforation on the lesser curvature of the gastric body. The patient was treated nonsurgically with fasting, intravenous fluids, antibiotics, intravenous proton pump inhibitors, and blood transfusions. No leakage was observed on the follow-up computed tomography scan, and the perforation site was completely healed 2 months later. Conclusion: In this case, the patient was successfully treated with conservative therapy alone. The treatment of gastric perforation caused by endoscopy has shifted toward conservative therapy in recent years.

Successful resolution of gastric perforation caused by a severe complication of pancreatic walled-off necrosis: A case report.

BACKGROUND: Pancreatic walled-off necrosis (WON) rarely causes critical gastric necrosis and perforation, which may develop when pancreatic WON squashes against the stomach. The Atlanta 2012 guidelines were introduced for acute pancreatitis and its related clinical entities. However, there are few reported cases describing the clinical course and resolution of pancreatic WON. CASE SUMMARY: We report the case of a 45-year-old man who presented to the urgent emergency department with gastric perforation caused by a severe complication of pancreatic WON on computed tomography. The patient underwent an emergency distal pancreatectomy, splenectomy, and gastric wedge resection. Postoperative findings showed re-perforation of the gastric wall at a previously resected margin. Furthermore, endoscopic examination revealed an ulcerative area with a defect in the fundus. After diagnostic endoscopy, endoscopic vacuum-assisted closure was performed, and continuous suction was transferred over all tissues in contact with the sponge surface. The patient recovered without any further complications and was discharged in good condition at postoperative week 8. No recurrence occurred during the 6-mo follow-up period. CONCLUSION: When managing a patient with serious gastric perforation complicated by pancreatic WON, a multidisciplinary treatment approach should be considered.

Clinical presentation and outcome of gastric impactions with or without concurrent intestinal lesions in horses.

BACKGROUND: Gastric impactions (GI) have been identified as primary lesions (lone GI; LGI) or associated with other intestinal lesions (concurrent GI; CGI). Anecdotally, CGI resolve more rapidly with a better prognosis than LGI. OBJECTIVES: To determine clinical, laboratory, and ultrasonographic findings, and short- and long-term survival in horses with GI. We hypothesized that LGI carries a worse prognosis than CGI. ANIMALS: Seventy-one horses from 2 referral hospitals (2007-2022). METHODS: Retrospective cohort study. Gastric impactions were defined as feed extending to the margo plicatus after ≥24 hours of fasting. Clinical, diagnostic and outcome findings were compared between LGI and CGI. Long-term survival was determined by a questionnaire. RESULTS: Twenty-seven horses had LGI, 44 had CGI. Large intestinal lesions (32/44) were more common than small intestinal lesions (12/44). Concurrent gastric impactions resolved more slowly than LGI (LGI median 2 days, range 0-8; CGI median 4 days, range 1-10; P = .003). Short- (LGI 63%, 17/27; CGI 59%, 26/44; P = .75) and long-term survival (LGI 3.5 ± 1.9 years; CGI 2.3 ± 2.3 years; P = .42) were not significantly different. However, Lone gastric impactions were more likely to experience gastric rupture (LGI 29.6%, 8/27; CGI 11.4%, 5/44; P = .05). Lone gastric impactions were 8.7 times more likely to require dietary changes (LGI 72.7%, 8/11; CGI 25%, 4/16; 95% confidence interval [CI], 1.53-49.22; P = .01). Gastric impactions recurred in 21.7% (LGI, 6/20; CGI, 4/26; P = .23) of affected horses. CONCLUSIONS AND CLINICAL IMPORTANCE: Lone gastric impactions and CGI present similarly with a comparable prognosis, but LGI are more likely to rupture. Long-term dietary changes are often necessary for horses with LGI.

Carbonated Beverages and Puffed Foods Cause Gastric Rupture.

INTRODUCTION: Carbonated beverages and puffed foods are popular among young people during leisure and entertainment. However, there have been a few death cases reported after ingesting large amounts of junk food in a short time. CASE PRESENTATION: A 34-year-old woman was admitted to the hospital with acute abdominal pain due to a bad mood and consumption of large amounts of carbonated beverages and puffed foods. Emergency surgery revealed a ruptured dilated stomach combined with severe abdominal infection, and the patient died after the surgery. CONCLUSION: We should keep in mind the possibility of gastrointestinal perforation in patients with acute abdomen with a history of heavy consumption of carbonated beverages and puffed foods. We need to evaluate the acute abdomen patients after taking large amounts of carbonated beverages and puffed foods in combination with symptoms, signs, inflammatory indicators, imaging and other examinations, and the possibility of gastric perforation needs to be considered, and emergency repair surgery should be arranged.

Gastric rupture during fiberoptic bronchoscopy, a rare complication of oxygen administration by nasopharyngeal cannula: a case report.

Concomitant use of a nasopharyngeal catheter is frequently used for oxygen supply during fiberoptic bronchoscopy (FOB). This is a procedure that presents possible complications that are not negligible. We demonstrate the case of a 61-year-old woman who underwent FOB due to a history of hemoptoic sputum. During the procedure, gastric rupture occurred with a large pneumoperitoneum and bilateral pneumothorax requiring immediate drainage of the air and an emergent laparotomy. This was probably a complication of the nasopharyngeal catheter. The knowledge of these complications is essential for their correct identification and treatment.

Gastric rupture during fiberoptic bronchoscopy, a rare complication of oxygen administration by nasopharyngeal cannula: a case report

Abstract Concomitant use of a nasopharyngeal catheter is frequently used for oxygen supply during fiberoptic bronchoscopy (FOB). This is a procedure that presents possible complications that are not negligible. We demonstrate the case of a 61-year-old woman who underwent FOB due to a history of hemoptoic sputum. During the procedure, gastric rupture occurred with a large pneumoperitoneum and bilateral pneumothorax requiring immediate drainage of the air and an emergent laparotomy. This was probably a complication of the nasopharyngeal catheter. The knowledge of these complications is essential for their correct identification and treatment.

Clostridioides (Clostridium) difficile-associated disease, epiploic foramen entrapment, and gastric rupture in a Thoroughbred racehorse: case report and literature review.

Epiploic foramen entrapment (EFE) is a common cause of small intestinal colic in horses and may lead to intestinal strangulation. Strangulating intestinal obstruction impairs the gastrointestinal outflow and can lead to secondary gastric rupture and endotoxemia. Clostridioides difficile can cause enterotyphlocolitis with colic in horses of all ages, and the process is commonly referred to as C. difficile-associated disease (CDAD). Here we report the results of the postmortem examination of a 7-y-old Thoroughbred racehorse with concurrent CDAD, EFE, and gastric rupture that was euthanized following a history of colic over several days. A segment of distal jejunum and proximal ileum had passed through the epiploic foramen, and the intestinal wall was thickened and dark-red. The remaining small intestinal loops were distended and filled with blood-tinged contents. Peritonitis had resulted from escape of gastric contents into the abdominal cavity through a tear in the major curvature of the stomach. Histologically, the incarcerated segment had acute transmural hemorrhage with congestion and mucosal necrosis; neutrophilic infiltrates with fibrin thrombi were in the mucosa of the non-incarcerated small intestinal segments. C. difficile toxins were detected in the small intestinal contents, and C. difficile was isolated from the small intestine, colon, and cecum.

Binge-eating episode as a direct cause of death in a young individual without eating disorder.

Binge eating is characterised by the ingestion of large quantities of food in a short time. Cases in the literature deal exclusively with gastric perforation in people with a history of anorexia nervosa, binge eating disorder or bulimia nervosa.We report the case of a young woman with no previous diagnosis of mental illness and a history of only two binge-eating episodes that occurred a few years earlier. She died suddenly during a binge-eating episode from stomach rupture resulting from a single perforation of the stomach with leakage of food material within the abdominal cavity. There was no sign of gastric necrosis or peritonitis. The deceased died quickly.Our case, which appears unique in the literature, shows that there is a risk of death even in people with no diagnosis of eating disorders and a history of only few and isolated binge-eating episodes. Physicians should carefully investigate a patient's history to assess any risks.

Gastric rupture following multiple blunt trauma.

Gastric injury due to trauma is a rare complication that occurs in approximately 0.04%-1.2% of all instances of abdominal trauma. When imaging trauma cases, certain areas can be obscured by several inevitable reasons. Despite its rarity, the high mortality rate of a gastric injury requires an early and accurate diagnosis. We present the case of an 18-year-old male who suffered a gastric rupture of the greater curvature following a road traffic collision before providing a brief review of the literature.

A large gastric rupture due to blunt trauma: a case report and a review of the Japanese literature.

Gastric rupture due to blunt trauma is rare, occurring in only 0.07-1.2% of all abdominal blunt traumas. We reported a case with a 10-cm-long hole and review 25 cases in Japan. A 22-year-old man was involved in a traffic accident, 2 h after eating a lot of food. He had suffered muscular defense in the abdomen. An abdominal computed tomography (CT) scan revealed free air, disruption of the gastric wall and a lot of food residue. The laparotomy showed a burst of 10 cm that ran parallel to the long axis from the cardia to the body. A simple closure was primarily performed and drains were placed in the abdominal cavity. The patient was discharged on the 32nd day. Most cases of gastric rupture are diagnosed intraoperatively, but careful evaluation of CT scans and patient interviews are needed to make an accurate preoperative diagnosis.

Never seen right gastrothorax: A case report.

Traumatic gastrothorax, or stomach herniation into the chest post-trauma, is a rare but dangerous condition that can lead to respiratory distress and obstructive shock. Its diagnosis is challenging and requires a high index of suspicion. Immediate stomach decompression is an important, often life-saving step of the treatment, prior to definitive surgical repair. We report herein the case of a 59 year-old female patient, who was involved in a severe motor vehicle accident resulting in multiple injuries. Her right-sided gastrothorax, manifesting as solely nausea at first, was only diagnosed 16 days after trauma, intraoperatively. Worse, her herniated stomach had ruptured within the right pleural cavity causing pneumothorax, spillage of contents and pleuritis. It was an erroneous radiological diagnosis of right lung necrosis which halted surgical management. Right gastrothorax has never been reported previously. This article also reviews the condition's pathophysiology, along with diagnostic and therapeutic modalities, and sheds light on the importance of its early recognition and treatment.

Gastric Perforation: A Rare Accident from Intubation.

Perforation of a gastrointestinal tract as a complication of intubation is unusual, and only few cases have been reported. Prompt recognition and management of gastrointestinal tract perforation are needed to limit the morbidity and mortality of this condition. We presented a case of an acutely ill patient who developed gastric perforation following difficult intubation to remind clinicians of a life-threatening complication that can develop following a life-saving procedure.

Ruptura gástrica por mecanismo de bolsa de papel por trauma cerrado de abdomen. Reporte de un caso / Gastric rupture due to paper bag mechanism because of a closed abdominal trauma. A case report

Resumen A pesar de que el trauma abdominal contuso es una entidad frecuente, su asociación con lesión gástrica es rara (aproximadamente 1.7%); sin embargo, es una posibilidad que siempre debe considerarse durante su evaluación. Además de su trascendencia como hallazgo aislado, es esencial su correlación con otras lesiones. Presentamos el siguiente caso no sólo por la escasa frecuencia con la que se observan este tipo de lesiones, sino por sus características clínicas anómalas, las cuales -salvo por el mecanismo del trauma- hicieron prácticamente imposible su sospecha.

Abstract Although closed abdominal trauma is a frequent entity, its association with gastric injury is rare (approximately a 1.7%); however, it is a possibility that should always be taken into consideration during its evaluation. In addition to its transcendence as an isolated finding, its correlation with other lesions is essential. We present the following case not only because of the low frequency with which these sort of lesions are observed, but also because of its anomalous clinical features that make any suspicion virtually impossible, except for the mechanism of the trauma.

Laparoscopic evaluation and management of isolated gastric rupture in a boy after blunt abdominal injury.

Blunt abdominal injury in children can be a significant diagnostic and therapeutic challenge. The extent and localization of organ damage cannot be always thoroughly investigated noninvasively and in spite of modern imaging techniques and a laparotomy may be necessary for diagnosis, even though it carries a significant morbidity. We present a rare case of isolated gastric rupture after blunt abdominal injury in a 12 year old boy that sustained a bicycle accident. He was hemodynamically stable, had signs of acute abdomen and axial tomography was inconclusive as of the site of visceral perforation. Definitive diagnosis and treatment were carried out laparoscopically with excellent results. Laparoscopic surgery in cases of blunt abdominal injury with gastric rupture can serve both as a diagnostic and therapeutic modality with the additional advantage of being less traumatic. The accumulation of relevant experience is mandatory in order to establish this modality in the diagnostic and therapeutic protocols.

Ruptura gástrica. Informe de un caso / Gastric rupture. Case report

Resumen La expresión abdomen agudo en pediatría implica el concepto de una emergencia médica de origen abdominal. En los primeros días de la vida, las anomalías digestivas congénitas (presentes en aproximadamente 1 de cada 5000 recién nacidos) constituyen la causa más importante de abdomen agudo. La ruptura gástrica es un cuadro que puede describirse como causa de catástrofe intraabdominal, pudiendo ocasionar shock y muerte del paciente. Este trabajo describe un caso de ruptura gástrica espontánea en un niño de tres años de edad, con cuadro clínico de más o menos 12 horas de evolución, consistente en dolor abdominal asociado a náuseas, distensión abdominal. La madre refirió que no ha había deposiciones ni flatos. Ecografía abdominal reportó abundante líquido en cavidad abdominal. El niño fue llevado a quirófano y falleció.

Abstract The expression acute abdomen in pediatrics, implies the concept of a medical emergency of abdominal origin. In the first days of life, congenital digestive abnormalities (those present in about 1 in 5000 infants) are the most important cause of acute abdomen. Gastric rupture is a condition that can be described as the cause of intra-abdominal cataracts, which can cause shock and death of the patient. This paper describes a case of spontaneous gastric rupture in a 3-year-old boy with a clinical picture of about 12 hours of evolution consisting of abdominal pain associated with nausea, abdominal distension, the mother who has not had bowel movements Abdominal ultrasound reports abundant fluid in the abdominal cavity, which is taken to the operating room and dies.

Spontaneous gastric rupture after Sodium Bicarbonate consumption: A case report.

Spontaneous gastric rupture is a rare condition however a prompt diagnosis and treatment are necessary to decrease mortality and morbidity. We report a case of stomach rupture after the ingestion of Sodium Bicarbonate (SB); imaging findings with a brief review of the literature are presented.

Isolated Double Gastric Perforation in Blunt Abdominal Trauma-a Case Report.

Blunt abdominal trauma mostly results from motor vehicle accidents, recreational accidents, falls or assaults with commonly injured internal organs being the spleen, liver, retroperitoneum, small bowel, kidneys, bladder, colorectal, diaphragm and pancreas. Gastric rupture is quite uncommon. Isolated gastric perforations following blunt trauma to the abdomen are mostly seen in paediatric patients. It is uncommon in adult patients and even rarer is the occurrence of double gastric perforations. We report here with a case of isolated double gastric perforation in a 24-year-old male patient following vehicular accident.