# Stomach blowout post binge-eating episode: a case report

## TL;DR

A young woman with an eating disorder developed severe stomach complications after a binge-eating episode, requiring emergency surgery.

## Contribution

This case report highlights acute gastric necrosis and perforation as rare but life-threatening complications of binge-eating in eating disorder patients.

## Key findings

- Acute gastric dilatation led to necrosis and perforation in a patient with an eating disorder.
- Early surgical intervention was crucial for successful recovery.
- Subcutaneous emphysema, pneumothorax, and portal venous air were observed as complications.

## Abstract

Acute gastric dilatation is a rare but serious condition that can lead to ischemia, necrosis, and perforation of the stomach. This case report describes a 21-year-old female patient with an eating disorder who developed acute gastric necrosis and perforation following a binge-eating episode. A 21-year-old female with a history of eating disorder not otherwise specified presented to the referring hospital with severe abdominal pain, and on physical examination, the suspicion of subcutaneous emphysema. Chest radiography showed the subcutaneous emphysema and also revealed a pneumothorax and a possible pneumomediastinum. Her condition deteriorated, prompting a CT scan that showed extensive pneumomediastinum, subcutaneous emphysema, a massively distended stomach, and portal venous air. The patient was transferred to our hospital, where further imaging confirmed these findings. After further deterioration and a suspected perforation, a second CT scan was performed, confirming a gastric perforation with extensive free fluid in the abdomen. An exploratory laparotomy revealed gastric perforation with necrosis and peritonitis, necessitating a sleeve gastrectomy. The patient underwent successful surgery with resection of necrotic gastric tissue and sleeve gastrectomy. Postoperative recovery was uncomplicated, and follow-up showed no further complications. Early surgical intervention was crucial in managing this life-threatening condition. Acute gastric dilatation and subsequent necrosis are rare but potentially fatal complications in patients with eating disorders. Prompt recognition and surgical intervention are essential to reduce morbidity and mortality.