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J Korean Soc Emerg Med > Volume 14(5); 2003 > Article
Journal of The Korean Society of Emergency Medicine 2003;14(5): 677-679.
Gasric Rupture as the Result of a Binge-Eating after a Abstinence Prayer
Joon Ho Cho, Sun Wook Kim, Yoo Sang Yoon, In Cheol Park, Seung Ho Kim
Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea. edksh@yumc.yonsei.ac.kr
Spontaneous gastric rupture is a very rare disease and may be related to the consumption of large meals. We experienced a rare case of gastric rupture due to binge eating. A 57-year-old woman visited the emergency department with an abdominal distention following binge eating after a two day abstinence prayer. A plain abdominal X-ray showed free air in the subphrenic space and a markedly distended stomach. At laparotomy, the stomach was dilatated and ruptured about 7 cm from the esophagogastric junction to the lesser curvature. A total gastrectomy was done, but at 11 days, the patient expired due to sepsis. Causes of acute gastric dilatation are various and include binge eating. Massive gastric dilatation leads to a decrease in intramural blood flow and gastric infarction. Symptoms of gastric dilatation may be mild, but are progressive. Diagnosis can be made by observing free air or a distended stomach on a simple abdominal X-ray. Treatment should begin with nasogastric decompression and fluid resuscitation. If conservative treatment fails or if gastric infarction or perforation is suspected, surgical intervention is mandatory.
Key words: Gastric rupture, Binge eating, Gastric dilatation
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