Cases reported "Stomach Rupture"

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1/25. Neonatal gastric volvulus.

    Three infants with acute gastric volvulus occurring during the first week of life are presented, bringing the total number of cases reported in the neonatal period to nine. Abdominal radiographs and constrast studies of the upper gastrointestinal tract were nearly identical in all three infants and showed a characteristic pattern that allowed unequivocal preoperative diagnosis. It is essential that the radiologist recognize the radiographic features of acute gastric volvulus, since prompt operative intervention is mandatory to prevent late complications, which include gastric perforation and death.
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2/25. Gastric perforation caused by a bulimic attack in an anorexia nervosa patient: report of a case.

    We report a rare case of gastric perforation due to a bulimic attack in a 17-year-old girl suffering from anorexia nervosa. She was admitted to our hospital with the chief complaint of abdominal pain following bulimia. Initially, her symptoms were reduced after drainage using a nasogastric tube. Eight hours later, however, she fell into a state of preshock. Abdominal radiography revealed subphrenic free air. We diagnosed the patient as having diffuse peritonitis. At laparotomy, the stomach was dilated and necrotic with perforation. Almost the entire stomach was resected. Postoperatively, the patient recovered uneventfully. We should therefore be aware of this condition when treating patients with anorexia nervosa who complain of abdominal pain.
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keywords = abdominal pain
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3/25. Computed tomography (CT) findings of gastric rupture after blunt trauma.

    A 49-year-old carpenter was hit by timber around his upper abdomen 1 hour after breakfast. Immediate computed tomography was taken, followed by emergency laparotomy showing gastric rupture accompanied with hemorrhage from the superior mesenteric vein. hemostasis and distal partial gastrectomy followed by Billroth-I anastomosis reconstruction was performed. Here, we report the abdominal computed tomography findings from a patient with gastric rupture after blunt trauma. The present case, which is only the second such case reported in English literature, suggested that computed tomography is useful for assessing associated injuries in gastric rupture patients, for detecting intraperitoneal free air which can be missed by x-rays, and for locating the laceration of the rupture.
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4/25. A spontaneously ruptured gastric stromal tumor presenting as generalized peritonitis: report of a case.

    Among the diverse clinical presentations of gastrointestinal stromal tumor (GIST), spontaneous rupture with peritonitis is extremely rare. We report herein the unusual case of a 75-year-old man found to have a spontaneously ruptured gastric stromal tumor after presenting with generalized peritonitis. The patient was brought to the emergency department of our hospital by ambulance, with generalized severe abdominal pain. On examination, his abdomen was extensively distended with generalized severe rebound tenderness. Abdominal computed tomography scan showed a giant mass arising from the anterior gastric wall with an irregular internal low-density area and a small amount of ascites. An emergency laparotomy revealed a ruptured gastric tumor with dissemination of its necrotic tissue throughout the peritoneal cavity. The tumor was excised together with normal gastric tissue around its base. The tumor, which was 15 x 11 x 4.4cm in size, had a coarse laceration over its well-capsulated smooth serosal surface with massive necrosis and clotted blood inside. Immunohistochemical examination revealed positive reactivity to C-kit protein, which was consistent with the newly introduced diagnostic criteria of GIST. The patient had an uneventful postoperative course and remains well.
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ranking = 174.22063623484
keywords = abdominal pain
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5/25. Gastric rupture caused by acute gastric distention in non-neonatal children: clinical analysis of 3 cases.

    OBJECTIVE: To study gastric rupture, a progressive, rapid and high mortality condition, caused by acute gastric distention (GRAGD) and its appropriate diagnosis and treatment. methods: The etiology, pathology, clinical manifestations and experiences in 3 children with GRAGD were reviewed. RESULTS: Case 1: After diagnosing GRAGD and stabilizing her shock with massive fluid replacement, gastrostomy was performed. Her postoperative course was uneventful because of fasting, suction, fluid infusion, correction of acidosis and supporting nutrition. Case 2: After diagnosing gastric distention which subsided with conservative therapy for 9 days, she suddenly had gastric rupture when she had not eaten for 6 days. She died of shock and had no chance for surgery. Case 3: The patient had sudden abdominal pain, distention and vomiting with severe shock for 4 days. Emergency surgery found gastric rupture and the method was the same as Case 1. The patient survived but has brain impairment. Case 1 and 3 showed multifocal transmural necrosis. CONCLUSIONS: Symptoms like overeating, bulimia, changes in kind of food, X-ray showing large distended stomach and massive pneumoperitoneum were seen after gastric rupture and can help to diagnose this condition. Clinical course of gastric distention with toxic shock progresses rapidly, however subsequent gastric rupture exacerbates the shock and makes the treatment difficult treatment. It is extremely important that a laparotomy be performed at once after stabilizing shock with massive fluid replacement. Postoperative nutritional support and fluid replacement will increase survival. It is very important that when gastric distention disappears after conservative therapy, the doctor should assess carefully whether the gastric wall recovery is under way by using effective methods of examination.
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ranking = 174.22063623484
keywords = abdominal pain
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6/25. Gastric rupture in a diver due to rapid ascent.

    A 37-year-old, experienced female diver developed gastric rupture due to rapid ascent from a depth of 37 meters. The incident was preceded by a heavy meal, intake of soda beverages, swallowing of air and water under water, and panic. Sharp abdominal pain was present immediately after surfacing and afterwards. Full abdominal distension developed within two hours after the ascent. No other diving-related pathology was found. Surgery was performed around three hours after the accident and revealed pneumoperitoneum, gastric rupture, gastric content in the abdomen cavity, and signs of acute peritonitis. On surgery, a 4-cm rupture of the lesser curvature was found and sutured. The patient was discharged eight days after the event.
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keywords = abdominal pain
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7/25. Gastric barotrauma in a scuba diver: report of a case.

    stomach rupture can occur as a consequence of the expansion of compressed air during rapid ascent after diving. We present the case of a middle-aged woman who suffered a gastric tear from surfacing too quickly after diving, and discuss the diagnosis and management of such patients by reviewing previously reported similar events. Gastric barotrauma should be suspected in divers who complain of abdominal pain, even in the absence of frank signs of peritoneal irritation. Although pneumoperitoneum is always present in these patients, it can also occur as a consequence of pulmonary barotrauma, making gastroscopy or radiological contrast studies, or both, essential for a definitive diagnosis. Surgical repair represents the treatment of choice for an active full-thickness tear and, if associated with arterial gas embolism or decompression sickness, should ideally be performed in a center where a category I (intensive care-capable) hyperbaric unit is available.
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ranking = 174.22063623484
keywords = abdominal pain
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8/25. A spontaneously ruptured gastric stromal tumor with cystic degeneration presenting as hemoperitoneum: a case report.

    We report a case of a 38-yr-old man with a spontaneously ruptured gastric stromal tumor presenting as hemoperitoneum in outpatient clinic. He visited our hospital with generalized abdominal pain after abdominal CT scan for the evaluation of the asymptomatic palpable abdominal mass. Repeated abdominal CT scan showed a size decrement of cystic mass compared with the previous abdominal CT scan, and newly developed fluid collection in the left paracolic gutter. An emergency laparotomy revealed a ruptured gastric stromal tumor with bloody fluid in the peritoneal cavity. Immunohistochemical examination revealed positive reactivity to C-kit protein and CD34. The patient presented with hemoperitoneum due to spontaneous rupture of the tumor, which is an extremely rare complication.
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ranking = 174.22063623484
keywords = abdominal pain
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9/25. Endoclipping for gastric perforation after endoscopic polypectomy: an alternative treatment to avoid surgery.

    A 47-year-old woman underwent endoscopic polypectomy of a villous adenoma in the lesser curvature of the gastric antrum. Shortly after the procedure, she complained of severe abdominal pain. An abdominal x-ray showed air under the diaphragm, suggestive of gastric perforation. On re-endoscopy, the cavity at the site of polypectomy was closed using endoscopically applied metallic clips. She was treated with intravenous hyperalimentation, omeprazole, and antibiotics for 10 days. Ingestion of food was started 10 days after admission, and she was discharged without any complaints. She is free of symptoms on follow-up after 8 months, and endoscopy showed complete healing of the perforation. The procedure is the third described for the stomach in the English literature and emphasizes the use of endoclipping in selected cases of small and well-defined perforations.
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ranking = 174.22063623484
keywords = abdominal pain
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10/25. Stapled gastroplasty for antral stricture after repair of neonatal gastric rupture: report of a case.

    The patient was the second of twin girls born at 32 weeks' gestation, weighing 1736 g. Abdominal distention was noted the day after birth, and abdominal x-ray showed free air in the abdomen. An emergent laparotomy with debridement and primary closure were performed for spontaneous gastric rupture. From the age of 8 months, the infant sometimes vomited after meals and was unable to gain weight. She was diagnosed, by upper gastrointestinal series and gastroscopy, with antral stricture with a normal prepyloric area and pylorus. The presence of an antral web, ulcers, or ectopic pancreatic tissue was excluded. There was sufficient distance between the stricture area and the pylorus. Stapled gastroplasty using an Endopath linear cutter stapler and a Proximate linear stapler was performed safely and quickly without injury to the normal pylorus or branches of the vagal nerve at the lesser curvature. The child's postoperative course was uneventful.
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