Acute Gastric Necrosis in a Teenager

Abstract

Gastric infarction is a rare condition often associated with high mortality due to a delay in diagnosis. The stomach which has a rich supply of blood is a rare site for such a condition. Gastric infarction has a long list of etiological factors. We report a case of a patient who was managed successfully following gastric infarction from gastric dilatation. An 18-year-old female student presented with a three-day history of abdominal pain associated with abdominal distension of two days. The abdomen was distended with generalized tenderness, rebound tenderness, and guarding. Bowel sounds were absent. Digital rectal examination was unremarkable, and a pregnancy test was negative. Biochemical tests were all normal. Intraoperatively, two litres of serosanguinous fluid was suctioned from the abdomen. About 300 mL of pus was suctioned from the pelvis. The gangrenous portion was resected, and repair was done in two layers using Conell and Lambert suture techniques. Acute gastric necrosis is a rare surgical condition that requires a high index of suspicion and prompts aggressive resuscitation and surgical intervention to obviate the high mortality rate associated with the condition.

A case report of hemoperitoneum as the primary presentation of gastric infarction in a SARS-CoV-2 positive patient

“…The surgical procedure ended with the irrigation of the peritoneal cavity, the short gastric arteries ligation, subtotal small bowel resection and the remaking of Roux-en-Y gastrojejunostomy. York et al 3 described a case of gastric necrosis with abdominal pain due to overfeeding, leading the patient to be admitted to the ICU. In this case, the authors describe that 2 L of serosanguineous exudate fluid from the stomach were extracted intraoperatively.…”

“…This event may be determined by vascular, chemical, mechanical or infectious etiologies 2 . The first case of a major gastric infarction was reported in 1909 by Baumann 3 . He described it as an accidental event at an autopsy of a 90-year-old woman.…”

Diffuse Arterial Atherosclerosis Presenting With Acute Ischemic Gastritis

“…Acute gastrointestinal bleeding due to ischemic gastritis as a result of celiac artery stenosis induced by atherosclerosis can be successfully treated with celiac artery stenting [18]. Surgical intervention is indicated in cases unresponsive to conservative medical therapy or those complicated by gastric perforation, gastric volvulus, and the development of gastric gangrene that might require partial gastrectomy [12][13][14].…”

“…Conservative therapy with intravenous fluids, antibiotics, intravenous proton pump therapy, and gastric decompression might lead to the complete resolution of ischemic gastritis [11]. Angiographic intervention is indicated in splanchnic vascular obstruction, while surgical intervention is indicated in cases of failure of conservative medical therapy, gastric perforation, gastric volvulus, and the development of gastric gangrene [12][13][14]. We present a rare case of diffuse arterial atherosclerosis presenting with acute ischemic gastritis.…”

A Rare Case of Acute Necrotizing Gastritis

“…Significant mortalities have been reported in recent publications even with aggressive management. The presence of circulatory collapse may be a significant contribution to mortality [ 8 ]. The treatment of gastric ischemia includes fluid resuscitation, low intermittent nasogastric suction to combat gastric distension, intravenous proton pump inhibitor therapy, and the select usage of broad-spectrum antibiotics if sepsis or gastric pneumatosis is present.…”