Massive Acute Gastric Dilatation in a Patient with Anorexia Nervosa

Panyko, Arpád; Vician, M; Dubovský, Martin

doi:10.1007/s11605-020-04715-2

Cited by 9 publications

(6 citation statements)

References 3 publications

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“…Among individuals with eating disorders (EDs), this condition has only been described on the basis of presumed acute etiology (i.e., acute gastric dilatation), clinically presenting with acute onset epigastric or left upper quadrant abdominal pain along with nausea, vomiting, and frequently abdominal distension. Proposed etiologies for the development of acute gastric dilatation, in those with restrictive EDs, have included: mechanical obstruction due to superior mesenteric artery (SMA) syndrome (Mascolo et al, 2015); following consumption of a large binge (Gyurkovics et al, 2006); in the setting of electrolyte disturbances (Panyko et al, 2020); secondary to gastroparesis, or slowed gastric emptying (Pitre et al, 2021); and secondary to gastric atonicity with distension developing upon resumption of food intake (Vettoretto et al, 2010). However, baseline gastric dimensions in malnourished individuals, secondary to restrictive EDs, have never been examined.…”

Section: Introductionmentioning

confidence: 99%

Gastric dilatation in patients with restrictive eating disorders

Gibson

Watters

Dee

et al. 2022

Intl J Eating Disorders

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Objectives To better understand gastric dimensions in patients diagnosed with restrictive eating disorders (EDs). Method In this retrospective study, 56 patients, with restrictive EDs, and 60 gender/age/race‐matched patients from an outpatient clinic, were studied. Difference in stomach size, between cohorts, was ascertained, and regression analyses were used to examine associations with stomach size in the ED cohort. Results Patients with EDs were found to have significantly enlarged gastric dimensions when compared to the control group (M:14.8 cm [SD: 3.2] vs. 11.4 cm [SD: 2.9], p < .0001). Among the ED cohort, blood urea nitrogen (BUN), on the day of imaging, positively correlated with gastric dimensions (r = .43, p = .0009), while hypoalbuminemia negatively correlated with gastric dimensions (r = −.37, p = .005). BUN and albumin nadir were also significantly associated with stomach size (r2 = .26, F[2,53] = 9.46, p = .0003). There was no significant correlation between gastric dimensions and ED diagnosis, percent ideal body weight, gender, duration of illness, engagement in vomiting behaviors, diagnosis of superior mesenteric artery syndrome, or use of promotility agents. Discussion Findings in this study suggest that malnutrition, secondary to EDs, may be associated with an enlarged stomach. The relationship between the gastric dimensions and reported GI symptoms in this population remain to be determined. Public significance There are many physiologic changes to the gastrointestinal system that develop with malnutrition but the contribution of these physiologic changes toward the reported GI symptoms and refeeding difficulties is unclear. This is the first study to suggest that patients with malnutrition, secondary to EDs, may be associated with an enlarged stomach, and this potential relationship requires further investigation.

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Section: Introductionmentioning

confidence: 99%

Gastric dilatation in patients with restrictive eating disorders

Gibson

Watters

Dee

et al. 2022

Intl J Eating Disorders

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“…A diagnosis of gastric outlet obstruction by pyloric channel and duodenal ulcers was made and supported by radiological imaging of severe gastric dilatation. Acute massive gastric dilatation is considered as an extreme distention of the stomach occupying the whole abdominal cavity from the diaphragm to the pelvis and from left to right [1]. Acute massive gastric dilatation may lead to ischemia, necrosis, and perforation of the stomach [2].…”

Section: Massive Gastric Dilatationmentioning

confidence: 99%

Massive gastric dilatation

Wei¹,

Peng²,

Liu³

2023

Korean J Intern Med

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“…Additionally, potassium was substituted, as atonicity of the proximal gastrointestinal tract may be intensified or aggravated by hypokalemia [10].…”

Section: Case Reportmentioning

confidence: 99%

Endoscopic management of giant gastric dilatation in an anorexia nervosa patient after binge eating

Wiedbrauck

Hollerbach

2021

Z Gastroenterol

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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.

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Massive Acute Gastric Dilatation in a Patient with Anorexia Nervosa

Cited by 9 publications

References 3 publications

Gastric dilatation in patients with restrictive eating disorders

Gastric dilatation in patients with restrictive eating disorders

Massive gastric dilatation

Endoscopic management of giant gastric dilatation in an anorexia nervosa patient after binge eating

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