Acute massive gastric dilatation causing ischaemic necrosis and perforation of the stomach
Autor: | Maitham A. Moslim, Gareth Morris-Stiff, Jay Mittal, Gavin A. Falk, Jeffrey S. Ustin |
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Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_specialty Vomiting Exploratory laparotomy Gastric Dilatation medicine.medical_treatment Perforation (oil well) Gastroenterology Article Diagnosis Differential Stomach Rupture 03 medical and health sciences Postoperative Complications 0302 clinical medicine Gastrectomy Laparotomy Internal medicine medicine Humans Intubation Gastrointestinal business.industry Stomach digestive oral and skin physiology General Medicine Middle Aged medicine.disease digestive system diseases Surgery Volvulus Bowel obstruction Jejunum medicine.anatomical_structure 030211 gastroenterology & hepatology business Intestinal Obstruction 030217 neurology & neurosurgery |
Zdroj: | BMJ Case Reports. :bcr-2016 |
ISSN: | 1757-790X |
Popis: | Acute massive gastric dilatation (AMGD) is a rare distinctive condition but associates with high morbidity and mortality. Though usually seen in patients with eating disorders, many aetiologies of AMGD have been described. The distension has been reported to cause gastric necrosis with or without perforation, usually within 1–2 days of an inciting event of AMGD. We report the case of a 58-year-old male who presented with gastric perforation associated with AMGD 11 days after surgical relief of a proximal small bowel obstruction. The AMGD arose from a closed loop obstruction between a tumour at the gastro-oesophageal junction and a small bowel obstruction as a result of volvulus around a jejunal feeding tube. To our knowledge, this is the first case of a closed loop obstruction of this aetiology reported in the literature, and the presentation of this patient’s AMGD was notable for the delayed onset of gastric necrosis. The patient underwent an exploratory laparotomy and a partial gastrectomy to excise a portion of his perforated stomach. Surgeons should be aware of the possibility of delayed ischaemic gastric perforation in cases of AMGD. |
Databáze: | OpenAIRE |
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