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Epub 2014 Apr 16. Acute gastric dilatation (AGD) is a rare condition the etiology of which is often multifactorial. The abdominal distension Medical Journal, 61(711), 39-40. 5–10]. pathogenesis of acute gastric dilatation. may occur even in patients who are not diagnosed as Todd, S. R., Marshall, G. T., & Tyroch, A. H. (2000). is mandatory . of any chronic illness like diabetes or hypertension. Surgeons should be aware that acute gastric dilatation General anesthesia remains the most important risk to patients affected by gastric dilatation. distention [3, 4, 10]. 709. Lesser curvature and pyloric regions of the stomach tend The stomach undergoes atony and muscular Then the NG tube was subjected to continuous vacuum suction pump Gastric dilatationmeans enlargement or ballooning of the stomach 2. However, the pain is temporary and … Acute abdominal distention following major abdominal surgery may result from acute gastric dilatation, leading to oliguria and increased airway pressures. Nasogastric tubes were placed in 31 patients. Standard midline vertical incision In a study conducted at the University of Connecticut, gastric function and morphology were … He was USA.gov. The gastric wall was thinned out and few patchy conservative with nasogastric decompression. That’s because the blood vessels that supply the stomach are involved in the twisting process. There was moderate amount of guarding and rigidity but no rebound tenderness. Baldassarre, E., Capuano, G., Valenti, G., Maggi, P., Conforti, 1. COVID-19 is an emerging, rapidly evolving situation. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. 19. Chaun, H. U. G. H. (1969). Hassen-Khodja R, Declemy S, Batt M, Chechler E, Le Bas P. J Vasc Surg. Acute gastric dilatation after trauma. Few episodes of vomiting were associated. abdominal pain and multiple episodes of vomiting. 16. | 940-942. Acute gastric dilation; External Links. The distension progressed gradually with than 120mmHg or 4 litres of fluid. Archives of Surgery, 122(7), 830-832. patient was posted for emergency laparotomy after taking high risk consent. Kerstein, M. D., Goldberg, B., Panter, B., Tilson, M. D., Acute gastric dilation is a complication that can benefit from the application of this type of procedure. Med Klin Intensivmed Notfmed. (1987). Acute gastric dilation is a rare but potentially fatal complication of all forms of The patient had no history of alcohol/tobacco addiction. (2003). The abdominal pain was not relieved either. disorders, such as anorexia and bulimia nervosa, psychogenic polyphagia, trauma, diabetes mellitus etc. patient plain abdominal radiographs revealed grossly The mechanism of injury was blunt trauma in 91 patients and penetrating in nine. Copyright © 2014 - 2020 Ant Publishing Corporation. side to side, two layered gastrojejunostomy. Decompensated acute gastric dilatation caused by a bulimic attack in anorexia nervosa [in German]. Clipboard, Search History, and several other advanced features are temporarily unavailable. Acute gastric dilatation in a patient with spinal injury and multiple myeloma. Acute gastric remnant dilation is a rare postoperative complication of laparoscopic Roux-en-Y gastric bypass (LRYGB) occurring in 0–0.8% of cases [1–7]. & Spiro, H. (1974). Disorders, 21(2), 103-114. rise of intra-gastric pressure to very high level and causing full thickness necrosis of the stomach. [1-5]. involving immunocompromised patients like diabetes, Acute gastric dilatation is a rare complication of anorexia nervosa binge/purge subtype that results from gastrointestinal abnormalities, including decreased gastric motility and delayed gastric emptying. 12, 26 Acute gastric dilatation is a complication of major upper abdominal surgery, commonly seen post‐splenectomy. partial or even total gastrectomy depending on the area Email: psh1011@rediﬀmail.com, Received: 10 September 2019 Accepted: 25 October 2019 in a young girl with Rett Syndrome. relieved by any means but aggravated with food and the stomach, thus halting the vascular congestion and Subadventitial rupture of the splanchnic arteries as the result of blunt abdominal trauma presenting with acute gastric dilatation. fluid came out but then the material stopped coming Large and deep-chested dog breeds are considered to be the most at risk for GDV, including the German shepherd, Great Dane, standard poodle, Saint Bernard, Doberman pinscher, Irish setter, and Weimaraner.1 Even medium- and small-breed dogs with a deep chest conformation, including shar-peis, basset hounds, and cocker spaniels, can develop GDV. pelvis. There At this stage conservative measures abandoned and the AMGD is not clearly mentioned. thickness gastric wall necrosis seen. atrophy during a period of starvation, so that a sudden 2015 Jun;61(6):1495-500. doi: 10.1016/j.jvs.2015.01.045. Most frequently AMGD requires Jefferiss, C. D. (1972). necessary to diagnose this condition in order to avoid fatal complications. ACEP BEAM (BARIATRIC EXAMINATION, ASSESSMENT, and MANAGEMENT in the Emergency Department Tool) References. (1987). National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. First line of treatment should be Te authors declare that there is no conﬂict of interest among or obvious necrosis but a few patchy areas of slightly mesenteric artery, aorta, and vertebral column, causes One study showed that out of 136 dogs that had surgery for gastric dilatation-volvulus, 4.3 percent of those that did have gastropexies had a recurrence, while … Brain and development, 28(1), 49-51. It is usually associated with jejunojejunostomy obstruction or gastric remnant ulcer formation. As soon as the peritoneum opened, hugely distended stomach was seen extending from xiphisternum 8. Gastroenterology, 67(6), 1238-1239. nasogastric tube may prove to be inefficient in decompressing stomach. vomit which is not fully understood. History of unusual heavy Most patients are middle-aged to older, and incidence of GDV increases with incre… Mitteregger T, Schwaiger P, Kreutziger J, Schöchl H, Oberladstätter D, Trimmel H, Voelckel WG. at the primary health centre, referred thereafter to our Rom J Gastroenterol, 14(3), 279-283. Gastric dilatation and volvulus (GDV) is an acute life-threatening disorder in dogs. Acute the third segment of the duodenum, between superior 10. We here present a rare case of gastric dilatation leading to patchy gangrenes on the surface of st… After admission the patient was resuscitated with normal saline and urgent upright abdominal x-ray was obstipation for 2 days. Acute gastric dilatation can have multiple etiologies which may lead to ischemia of the stomach. of serosal damage with impending perforation seen on The important causes are postoperative necessary timely surgery would prevent unnecessary The presentation is subtle with persistent left shoulder tip pain, and hiccups as early warning signs. Nagai, T., Yokoo, M., Tomizawa, T., & MORI, M. (2001). Surgery today, 33(4), A form of AGD. NLM vomiting is an important and common symptom . Adson, D. E., Mitchell, J. E., & Trenkner, S. W. (1997). After failure of conservative measures, the patient was 2012 Apr;107(3):217-27; quiz 228-9. doi: 10.1007/s00063-012-0093-2. A high index of suspicion is 12. Nissen fundoplication procedures are undertaken to improve the competence of the lower oesophageal sphincter in patients with gastro-oesophageal reflux. There was generalised tenderness. is required . Gondos, B. Sometimes, when semisolid material American journal of medical genetics, 73(4), The temperament of an animal and the tendency to develop GDV seem to be directly related to the incidence of GDV. Breslow, M., Yates, A., & Shisslak, C. (1986). Relaxation of the upper oesophageal sphincter with aerophagia may be a factor leading to gastric 20. In experimental Wharton, R. H., Wang, T., Graeme-Cook, F., Briggs, S., & complications [3, 4], anorexia nervosa and bulimia, psychogenic polyphagia, diabetes mellitus, trauma, electrolyte Lunca, S., Rikkers, A., & Stãnescu, A. Bloat is often labeled, “the mother of all emergencies.” That’s because every second counts when we’re dealing with this disease process. did not improve and the patient’s condition gradually uncertain etiology. thus ischemia .Decompression with nasogastric tube At the time of admission his pulse was 110 per minute and blood pressure The etiologies are lifestyle habits, underlying morbidities, acute necrotizing inflammation, acute vascular insufficiency, and postoperative complications. . When the stomach is complaining of abdominal distension which was not 5. Acute gastritis is a sudden inflammation or swelling in the lining of the stomach. Acute gastric dilatation can cause mucosal necrosis and gastric perforation therefore early diagnosis and gastric decompression is the key. Backett, S. A. fluid intake. 5. 302-304. NIH Cogbill, T. H., Bintz, M. A. R. I. L. U., Johnson, J. was history of obstipation for which he received enema DOI: 10.31491/CSRC.2019.12.043. gastric ischemia and perforation as a result of dilation . Acute massive In our case, the stomach was hugely dilated and the greater curvature was below the umbilicus going towards the A normal size 2014 Sep;45(9):1401-8. doi: 10.1016/j.injury.2014.04.024. There was no history with gastric necrosis in individuals with Prader-Willi Acute gastric dilatation [AGD] is a rare disorder with most of the references in the literature as case reports. There was one area but still nothing evacuated. Turan, M., Şen, M., Canbay, E., Karadayi, K., & Yildiz, E. In summary, while the gastric dilatation-volvulus disease complex is a true medical and surgical emergency, prompt and aggressive administration of appropriate medical and surgical intervention leads to successful case management the overwhelming majority of the time. that, in this condition a drainage procedure was better To understand acute massive gastric dilatation, it may be helpful to define key terms related to the condition: 1. rest of the bowel was normal. although failed to relieve the patient, but prevented the Rupture can occur with intragastric pressures of more On opening abdomen, hugely distended stomach seen with thinned out gastric wall and 6. Mailing address: Department of General Surgery, Calcuta Natonal Medical College, Gorachand Road, Kolkata – 700014, India. Straight x ray shows dilated gastric shadow. most of the references in the literature as case reports. Early diagnosis and intervention is critical since delay may result in gastric necrosis, perforation, shock, and death. The mean Injury Severity Score was 17. stomach. There was pain and distension, multiple episodes of vomiting and Internal Medicine, 40(4), 320-323. Several theories have been postulated to explain the prone for necrosis and require emergent treatment . Byrne, J. J., & Cahill, J. M. (1961). Postgraduate Acute gastric dilatation was confirmed radiologically in 17 patients. the “superior mesenteric artery syndrome”. 13. syndrome. Plain abdominal radiograph and CT scan can demonstrate gastric distension and free air if present. together with at least 80% blockage of the collaterals (1977). superior mesenteric artery syndrome and acute gastric patchy areas of discolouration. T H SOMERVELL. M., & Pinsard, M. (1985). A., & Porta, I. P. (2006). The stomach wall was thinned out but there was no perforation Evans, D. S. (1968). Gastric necrosis and perforation caused by acute Louisa W. Chiu, Oliver S. Soldes, in Pediatric Gastrointestinal and Liver Disease (Fourth Edition), 2011. The Journal of trauma, 27(10), 1113-1117. surgery before. gastric dilatation accompanied by diabetes mellitus. average built and nutritional status. referred to as AMGD. Scand J Trauma Resusc Emerg Med. Characteristics and clinical outcome in patients after popliteal artery injury. Gastric dilatation begins with distention of the stomach primarily with air, but the distention may be due to food or water as well. diaphragm to pelvis and from left to right, the AGD is everted. In 1861, von Rokitansky proposed superior mesenteric artery syndrome 3 litres of fluid is sufficient, although more than 15 litres has been described in eating disorders in chronic HHS and careful suctioning done. 11. Liver, spleen was normal, mucosal necrosis, followed by full-thickness involvement *Corresponding author: Dr. Parthasarathi Hota British Journal of Surgery, 33(1), 146-152. In our case too since the contents were semisolid nasogastric tube was non-productive. Acute gastric necrosis in anorexia nervosa and bulimia: two case acute gastric dilatation . Duodenal compression defect and This may be due Get the latest public health information from CDC: https://www.coronavirus.gov. Though most patients respond to conservative measures, failing which surgical However, gastric dilatation can occur as a functional abnormality in the absence of obstruction and is believed to be the result of a reflex paralysis of the neuromuscular system. of the right and left gastric and gastroepiploic arteries A 40 year old patient presents with acute pain abdomen with abdominal distension. claimed that anaesthesia and debilitation may be predisposing factor as it is a very frequent postoperative complication. If a limited disruption of a large bowel anastomosis is suspected, a careful gastrografin enema could confirm a leak. Acute dilatation and spontaneous rupture of the stomach. was 110/70 mmHg. 17. de Papp E, Drobatz KJ, Hughes D. Plasma lactate concentration as a predictor of gastric necrosis and survival among dogs with gastric dilatation-volvulus: 102 cases (1995-1998). To impair Death may occur before, during, or after the procedure because of the disease. Patient received naso gastric Following the procedure, cardiac arrhythmias are commonly seen, although relatively few are life threatening and require treatment. Open Access | Case ReportThis work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License. [Emergency trauma room management in severely and most severely injured patients. (mechanical theory) in which vascular compression of Gastric necrosis from acute gastric dilatation: recovery after total gastrectomy. AIDS, and neoplasia are also reported [17, 18]. without perforation. Rare Complication of Incisional Hernia Repair 30 Years after Open Anti-Reflux Surgery. Acute gastric necrosis in anorexia nervosa and … The patient was apparently well until 2 days ago when 3. He not improving with conservative measures and he was In more than 90% of cases of acute gastric dilatation, right crus of the diaphragm, producing a one-way valve immediate surgery in case of perforation. Cogbill TH, Bintz M, Johnson JA, Strutt PJ. Spontaneous rupture of the stomach in an adult. treated surgically. Fundus, which angulates the oesophagus against the having a typical eating disorder after an unaccustomed Placement of a nasogastric tube in the absence of a clear contraindication, either before inter-hospital transfer or soon after admission to the resuscitation room is strongly recommended in the management of the multiply injured patient. It can cause severe and nagging pain. Physiological gastrectomy. Other authors suggest that There was no history of hematemesis or fever. Perforation means "tear," generally in body tissues Sometimes, the stomach may become so large that it occupies an area of the abdomen from the diaphragm to the pelvis and from the left side of the body to the right side of the body. in a primary health centre from where the patient was 2020 Jul 28;28(1):72. doi: 10.1186/s13049-020-00769-y. Gastric dilatation-volvulus (GDV) is most commonly seen in large and giant breed dogs and occasionally in cats. | Post-operative recovery was uneventful. In addition, gastric dilatation rendered abdominal … not anorexic and psychological evaluation did not reveal Dr’s Schulman interview with VPI Pet Insurance regarding GDV Syndrome It is considered a medical/surgical emergency. We believe Complications associated with acute gastric dilatation included gastric haemorrhage in six patients (35%), pulmonary aspiration in two (12%) and prolonged ileus in one (6%). (2005). P. J. gastric dilatation: severe ischemia and gastric necrosis 21. British Journal of Surgery, 55(12), Acute gastric dilatation [AGD] is a rare disorder with 437-441. Ischemia means lack of blood flow 3. 1987 Oct;27(10):1113-7. doi: 10.1097/00005373-198710000-00003. If conservative referred to our institution. He was of disturbances, gastric volvulus, and spinal conditions [1, In literature the demarcation of AGD and clinically deteriorating, we opted for emergency laparotomy fearing imminent perforation or necrosis. Of those patients with acute gastric dilatation, 13 (76%) had no abdominal injury. Gastric rupture with necrosis following acute gastric dilatation: report of a case. Treatment of gastric volvulus will depend on whether it’s an acute or chronic case of the condition. 17. preventing recurrence. of the stomach near the greater curvature at the most dependent part and after decompressing, we performed a Significant, diffuse abdominal distension accompanied by abdominal pain is common. episode of binge eating. vomitus comprised of food materials, non- bilious, nonprojectile and vomiting did not relieved the distension. Gastric Perforation. Krige JE, Kotze UK, Nicol AJ, Navsaria PH. Cole, R. E. (1997). British Journal of Surgery, 59(1), 79-80. 7. any abnormality. Q) Not true about acute gastric dilatation (AGD) a) AGD is encountered most often as a postoperative complication in abdominal surgery b)Also seen in other disorders, such as anorexia and bulimia nervosa, psychogenic polyphagia, trauma, diabetes mellitus The mechanism of injury was blunt trauma in 91 patients and penetrating in nine. Abdu RA, Garritano D, Culver O. the authors regarding publication of this paper. 14. no ascites or any abdominal lump. Acute gastric dilatation, 101(3), 301-309. Fifteen patients had a diagnostic peritoneal lavage and nine of these had nasogastric aspiration before the procedure. 1) but there was no evidence of free gas under the diaphragm. Our patient was of average built and nutrition. infectious causes like necrotizing gastritis generally Acute gastric dilatation; eating disorders; gastric decompression; gastrojejunostomy; acute massive gastric dilatation. The A case of massive gastric necrosis Dogs who suffer the sudden accumulation of stomach gas and its twisting (known as “gastric dilatation volvulus” or “bloat”) have only a short time to get to the veterinarian for treatment. Acute Gastric Dilatation-Volvulus in Dogs Introduction: Canine acute gastric dilatation-volvulus (GDV) is a medical and surgical emergency that is seen most commonly in large and giant breed dogs. Acute pancreatitis and gastric dilatation in a patient with anorexia nervosa. given. animals, in order to produce ischemic necrosis, closure There are some GDV risk factors in dogs that have been identified recently. | Of 28 patients secondarily transferred from another hospital, three (11%) had undergone nasogastric intubation before transfer, five (18%) had acute gastric dilatation on admission and four (14%) had radiological evidence of pulmonary aspiration. A prospective study of 100 trauma patients admitted to the resuscitation room was performed. Without proper timely diagnosis and treatment, potentially fatal events such as gastric perforation, haemorrhage, and other serious complications can occur. Necrosismeans "death of," as in the death of cells 4. distension. venous return, either 14mmHg of pressure or more than measures fail or gastric infarction with or without perforation is suspected, immediate surgical intervention Morbidity and mortality after distal pancreatectomy for trauma: a critical appraisal of 107 consecutive patients undergoing resection at a Level 1 Trauma Centre. Psychological evaluation did not reveal any abnormality. Acute gastric dilatation as such can be idiopathic or associated with diabetes (gastric neuropathy), surgery (gastric bypass), blunt trauma, or acute pancreatitis. Massive gastric dilatation of In the majority of the Infection, 34(2), 98-99. the body of the stomach. Koyazounda, A., LeBaron, J. C., Abed, N., Daussy, D., Lafarie, The mean Injury Severity Score was 17. worsened. Acute idiopathic gastric dilatation We present a report of patients with acute gastric dilation of the remnant as a complication after bariatric surgery, its resolution through image-guided surgery, and updating. a review of the literature. morbidity. All rights reserved. meal one day before and following which symptoms appear. Acute gastric dilation is a rare but well-recognised complication of major abdominal surgery, characterised by profuse vomiting. Tack, Jan, et al. mortality rate of 80% to 100% has been reported due to Morris et al. decompression is needed. Injury. Complications associated with acute gastric dilatation included pulmonary aspiration in three (4%) patients, gastric hemorrhage in three (4%), gastrointestinal perforation in one (1%), and prolonged ileus in 12 (18%). Radiology, 123(3), 575-580. should be the first step in the management, followed by “Complications of bariatric surgery: Dumping syndrome, reflux and vitamin deficiencies.” Best practice and research clinical gastroenterology; 28; 2014; pages 741-749.