[Acute gastric dilatation in a bulimic patient; systemic efects].

OBJECTIVES

To demonstrate through a clinical case the systemic effetcss and complications that can arise after an acute gastric dilatation caused by an eating binge.

CLINICAL CASE: A young woman diagnosed of bulimia nervosa presents to the emergency room after a massive food intake. She shows important abdominal distention and refers inability to self-induce vomit. A few hours later she commences to show signs of hemodynamic instability and oliguria. A CT scan is performed; it shows bilateral renal infarctions due to compression of the abdominal aorta and some of its visceral branches.

INTERVENTIONS: The evaluation procedures included quantification of the gastric volume by CT. A decompression gastrostomy was performed; it allowed the evacuation of a large amount of gastric content and restored blood supply to the abdomen, which improved renal perfusion.

CONCLUSIONS

CT is a basic diagnostic tool that not only allows us to quantify the degree of acute gastric dilatation but can also evaluate the integrity of the adjacent organs which may be suffering compression hypoperfusion.