11/27. Gastric rupture after awake fibreoptic intubation in a patient with laryngeal carcinoma.An 86-yr-old man with recurrent laryngeal carcinoma developed gastric rupture after awake fibreoptic intubation before induction of general anaesthesia. Early clinical signs included a distended, tense and tympanic abdomen with pain and massive pneumoperitoneum (chest radiograph). laparotomy revealed a 4-cm longitudinal perforation along the lesser curvature of the stomach. This case represents a rare but severe complication that may occur during fibreoptic intubation in the awake patient.- - - - - - - - - - ranking = 1keywords = pain, chest (Clic here for more details about this article) |
12/27. Lethal gastric rupture caused by acute gastric ulcer in a 6-year-old girl.Gastric rupture is extremely rare in childhood beyond the neonatal period. We describe a previously healthy 6-year-old girl with a large laceration along the greater curvature on the posterior wall of the stomach. The patient was admitted to a neighboring hospital because of vertigo with 1-day history of intractable vomiting and epigastric pain. Although abdominal distension was noticed during the physical examination, muscular rigidity was not detected on palpation. Laboratory data showed severe hypotonic dehydration and moderate metabolic acidosis with hyperkalemia. She suddenly developed cardiac arrest within an hour after admission. After resuscitation, surgical consultation was obtained. Abdominal X-ray and ultrasound revealed abdominal free air and massive cloudy ascites. At laparotomy, there was a large laceration on the greater curvature of the stomach. pathology of the gastric wall showed mucosal necrosis while the musculature remained intact consistent with an acute gastric ulcer. Since clinical condition of gastric rupture deteriorates rapidly, early diagnosis and appropriate treatment is essential for good prognosis. One should consider that ulcer formation might cause gastric rupture in childhood.- - - - - - - - - - ranking = 0.87152145516281keywords = pain (Clic here for more details about this article) |
13/27. gastric dilatation and necrosis in bulimia: a case report.gastric dilatation and perforation is a rare complication in anorexia/bulimia sufferers. We describe a 24 year old female who presented with severe abdominal pain and vomiting, in whom radiographs demonstrated gross gastric dilatation and subsequent perforation. Although gastric perforation is rare, one can anticipate a rising incidence, with the apparent increase in the incidence of bulimia.- - - - - - - - - - ranking = 12.122749745363keywords = abdominal pain, pain (Clic here for more details about this article) |
14/27. Referred shoulder pain preceding abdominal pain in a teenage girl with gastric perforation.Referred shoulder pain is an important yet potentially distracting sign of serious intra-abdominal illness. A case is presented wherein shoulder pain preceded by several hours the onset of abdominal pain in a teenage girl with gastric perforation. The range of causes of gastric perforation and the pathophysiology of referred shoulder pain are discussed.- - - - - - - - - - ranking = 66.714398912957keywords = abdominal pain, pain (Clic here for more details about this article) |
15/27. Spontaneous rupture of the stomach in an adult.We have reported a case of spontaneous rupture of the stomach in an adult. Immediate onset of severe upper abdominal pain after overindulgence in food and drink along with radiographic evidence of pneumoperitoneum and the clinical findings of massive abdominal distention, epigastric tenderness, shock, and occasionally subcutaneous emphysema should suggest the possibility of gastric rupture. The treatment is simple, but mortality is high when surgical intervention is not rapid.- - - - - - - - - - ranking = 12.161667476486keywords = abdominal pain, pain, upper (Clic here for more details about this article) |
16/27. Traumatic rupture of the stomach after heimlich maneuver.Fatal complications following the performance of the heimlich maneuver have been reported. A 76-year-old woman presented to the emergency department with signs of respiratory distress, abdominal pain and distension one day after airway obstruction and subsequent resuscitation. Despite successful immediate laparotomy and repair of a ruptured stomach, she later succumbed to the sequelae of aspiration of gastric contents and dehiscence of the gastric tear. This is the 4th case of stomach rupture and the 7th reported fatal complication following the heimlich maneuver. It is recommended that persons who undergo the heimlich maneuver be examined and observed by a physician, as soon as possible, to rule out complications.- - - - - - - - - - ranking = 12.122749745363keywords = abdominal pain, pain (Clic here for more details about this article) |
17/27. Angiographic diagnosis of gastric volvulus with report of a complication following left gastric artery embolization.Gastric volvulus is a rare cause of upper gastrointestinal (UGI) tract obstruction and may present as acute UGI hemorrhage. The angiographic findings of gastric volvulus are discussed and a report of a complication of embolization of the left gastric artery in unsuspected mesenteroaxial stomach volvulus is given.- - - - - - - - - - ranking = 0.03891773112249keywords = upper (Clic here for more details about this article) |
18/27. Acute gastric necrosis in anorexia nervosa and bulimia. Two case reports.In recent years we have treated two patients with gastric infarction as a complication of anorexia nervosa and bulimia. We found only three other cases reported in the literature. Surgical intervention was delayed in all five patients either because the diagnosis was missed by the physician or because the patient failed to seek medical attention. physicians should be alerted to the possibility of acute gastric dilatation if a young woman, who may be undernourished and anorexic, complains of abdominal pain after ingestion of a large meal. Often this condition can be treated conservatively before irreversible damage to the gastric wall has taken place. If the gastric dilatation progresses, the stomach loses its contractility, resulting in venous occlusion, infarction, and gastric perforation. An extensive operation is required, and the patient undergoes an often complicated and prolonged hospital course.- - - - - - - - - - ranking = 12.122749745363keywords = abdominal pain, pain (Clic here for more details about this article) |
19/27. Rupture of the stomach in a diving accident with attempted resuscitation. A case report.A compressed air diver suffered pulmonary barotrauma with arterial air embolization; resuscitation was unsuccessful. Attempts at resuscitation included mouth-to-mouth ventilation and cardiac massage. A chest radiograph taken during resuscitation revealed free intraperitoneal air. Postmortem examination showed rupture of the stomach. The two possible aetiological factors--barotrauma of ascent and cardiopulmonary resuscitation--are discussed.- - - - - - - - - - ranking = 0.12847854483719keywords = chest (Clic here for more details about this article) |
20/27. Gastric rupture from blunt trauma. A plea for minimal diagnostics and early surgery.This paper reviews a series of gastric perforations resulting from blunt abdominal trauma. Over an 8-year period from January 1, 1974 to December 31, 1982, a total of 1412 patients were treated for significant intra-abdominal injuries. All injuries resulted from blunt abdominal trauma. patients were transported by helicopter to our statewide trauma center. Fourteen patients sustained 47 perforating injuries to the gastrointestinal tract; six patients (0.4%) had gastric perforations and averaged 1.3 associated intraabdominal injuries. The gastric injuries included three greater curve lacerations: one anterior wall tear, 10 cm long, extended through the esophagogastric junction, and two lacerations involved the anterior wall of the distal antrum. Five of the six patients (83.3%) complained of severe abdominal pain on admission and had bloody returns from subsequent peritoneal lavages. The sixth patient had two negative lavages 7 hours apart but underwent laparotomy for persistent symptoms. Five patients had upright chest roentgenograms, and one patient demonstrated free subdiaphragmatic air. patients with severe abdominal pain following blunt abdominal trauma require early celiotomy. Classic diagnostic findings, e.g., free intraperitoneal air, shock, and positive paracentesis, may be absent. The gastric injuries were repaired with a two-layer technique. Two patients (33%) developed intra-abdominal sepsis and required surgical drainage. One patient required pyloroplasty and vagotomy for stress-induced gastric bleeding. All six patients survived. The high mortality of gastric perforation can be mitigated by early diagnosis and surgical intervention.- - - - - - - - - - ranking = 24.373978035564keywords = abdominal pain, pain, chest (Clic here for more details about this article) |
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