Clinical observation
Massive Binge Eating, Gastric Dilatation and Unsuccessful Purging in a Young Woman with Bulimia Nervosa

https://doi.org/10.1016/j.jadohealth.2007.06.018Get rights and content

Abstract

This report describes the case of a young woman with bulimia nervosa who developed acute gastric dilation that was diagnosed by computerized tomography. The patient had no history of factors associated with delayed gastric emptying. The treatment course is reviewed, as is the pathophysiology of acute gastric dilation.

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)

There are more references available in the full text version of this article.

Cited by (18)

  • Medical Complications of Eating Disorders in Youth

    2019, Child and Adolescent Psychiatric Clinics of North America
  • Extensive gastric necrosis secondary to acute gastric dilatation: A case report

    2019, Legal Medicine
    Citation 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 Condes
  • An autopsy case of sudden death due to acute gastric dilatation without rupture

    2008, Forensic Science International
    Citation 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.

View all citing articles on Scopus
View full text