Clinical observationMassive Binge Eating, Gastric Dilatation and Unsuccessful Purging in a Young Woman with Bulimia Nervosa
Section snippets
Case
L.G. was a 21-year-old female with a 4-year history of bulimia nervosa. She began bingeing and purging during her first year at college following a series of familial, academic, and financial stressors. She reported that she initially began eating a variety of sweets in the evenings as a strategy to stay alert during her studies. She was unable to quantify her consumption, but she soon began to mechanically self-induce vomiting after eating these sweets 2 to 3 evenings per week. L.G. was first
Discussion
The presented case of gastric dilatation is unique in that it occurred in a normal-weight young woman with no prior or subsequent histories of anorexia nervosa, delayed gastric emptying, or gastric outlet obstruction. An additional unique aspect of this case is that the likely etiology of her inability to vomit is seen on the CT scan: the massive gastric dilatation has altered the gastroesophageal junction such that the distal esophagus is horizontal. This displacement has essentially created a
References (12)
Case of bulimia nervosa presenting with acute, fatal abdominal distension
Lancet
(1985)Integrated upper gastrointestinal response to food intake
Gastroenterology
(2006)- et al.
Massive gastric dilation after a single binge in an anorectic woman
Int J Eat Disord
(2006) - et al.
Severe gastric distention in seven patients with cerebral palsy
Dev Med Child Neurol
(1991) - et al.
Near-total gastric necrosis casued by acute gastric dilation
South Med J
(1988) - et al.
Gastric dilation and necrosis in bulimiaa case report
Aust Radiol
(1992)
Cited by (18)
Medical Complications of Eating Disorders in Youth
2019, Child and Adolescent Psychiatric Clinics of North AmericaExtensive gastric necrosis secondary to acute gastric dilatation: A case report
2019, Legal MedicineCitation Excerpt :Overdistention of the stomach precipitates parasympathetic paralysis, and decreased contraction exacerbates gastric dilatation [6]. Additionally, following dilatation of the gastric corpus, the angle between the esophagus and the right crus of the esophageal hiatus becomes more acute, and the esophagogastric junction functions as a one-way valve, causing obstruction [7] and difficulty in vomiting and promotes further gastric dilatation. Etiopathogenesis of gastric dilatation includes anesthetic-induced suppression of stomach motility after an abdominal operation, dilatation secondary to a central nervous system disorder, and overeating and overdrinking.
MEDICAL COMPLICATIONS OF EATING DISORDERS
2017, Revista Medica Clinica Las CondesAcute gastric dilation due to food gorging: Could be a life-threatening emergency
2010, Anales de PediatriaAn autopsy case of sudden death due to acute gastric dilatation without rupture
2008, Forensic Science InternationalCitation Excerpt :Acute gastric dilatation with infarction is recognized complication of trauma [33]. Previous reports of gastric dilatation [2–26,29,30] due to any cause (10 men, 21 women; age range, 14–91 years) are summarized in Table 2. Fifteen of the 31 cases had a definite episode of bulimia.
Massive Gastric Dilatation and Multi-Organ Ischemia Due to Superior Mesenteric Artery Syndrome: A Rare Case Report
2023, American Journal of Case Reports