금식 기도 후 폭식에 의한 위 파열 환자 1례

Abstract

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 twoday 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.