Ángeles-Velázquez JL, Hernández-Amador JF, Díaz-Greene EJ, Rodríguez-Weber FL

Language: Spanish
References: 14
Page: 196-202
PDF size: 572.18 Kb.

ABSTRACT

Acute gastric dilatation is a low-incidence nosologic entity, and potencially fatal due to high risk of gastric perforation. Its mortality is reported from 80 to 90%. It has been described with higher frecuency in women suffering from nutritional diseases such as anorexia nervosa, bulimia and psychogenic polyfagia, however, by means of a meticulous search, we can find a large number of case reports about diseases associated to acute gastric dilatation. This fact causes its physiopathology to be non-clear, but allows to identify risk factors and to create a therapeutic algorithm. Throughout this text we describe a case report of acute gastric dilatation in a female postoperated of Nissen fundoplication who simultaneosly coursed with acute gastroenteritis; finally we aimed to make a concise review towards this disease based on the data reported so far in the literature. We present the case of a 54-year-old female who underwent Nissen fundoplication four months before. She coursed with acute gastroenteritis, and afterwards she began with incapacitant abdominal pain and upper gastrointestinal bleeding followed by hemodynamic instability. She was treated with gastric decompression by exploratory laparotomy and gastrostomy catheter colocation. Acute gastric dilatation is a rare disease associated to Nissen fundoplication, and it must be considered a probable cause in the approach algorithm of abdominal pain, specially in patients that have the risk factors described in this text, regarding that its prevention and opportune treatment lower its mortality due to necrosis and gastric perforation.

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