Kimura A, Masuda N, Haga N, Ito T, Otsuka K, Takita J, Satomura H, Kumakura Y, Kato H, Kuwano H. Gastrojejunostomy for pyloric stenosis after acute gastric dilatation due to overeating. World J Gastroenterol 2015; 21(5): 1670-1674 [PMID: 25663789 DOI: 10.3748/wjg.v21.i5.1670]
Corresponding Author of This Article
Akiharu Kimura, MD, Department of General Surgical Science, Gunma University, Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan. a-kimura0615@hotmail.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Akiharu Kimura, Norihiro Masuda, Norihiro Haga, Tomokazu Ito, Kichirou Otsuka, Jyunko Takita, Hitoshi Satomura, Yuji Kumakura, Department of Surgery, Utsunomiya National Hospital, Tochigi 329-1193, Japan
Akiharu Kimura, Yuji Kumakura, Hiroyuki Kuwano, Department of General Surgical Science, Gunma University, Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
Kichirou Otsuka, Hitoshi Satomura, Hiroyuki Kato, Department of Surgery I, Dokkyo Medical University, Tochigi 321-0293, Japan
Author contributions: Masuda N performed the surgery; Kimura A and Otsuka K assisted with the surgery; Ito T, Takita J, Satomura H and Kumakura Y performed surgical management; Masuda N and Haga N revised the manuscript; Kato H and Kuwano H approved the final version of the manuscript; and Kimura A wrote the original manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Akiharu Kimura, MD, Department of General Surgical Science, Gunma University, Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan. a-kimura0615@hotmail.co.jp
Telephone: +81-27-2208224 Fax: +81-27-2208230
Received: June 18, 2014 Peer-review started: June 20, 2014 First decision: July 21, 2014 Revised: August 5, 2014 Accepted: September 19, 2014 Article in press: September 19, 2014 Published online: February 7, 2015
Abstract
A 34-year-old woman presented at our hospital with abdominal distention due to overeating. Acute gastric dilatation was diagnosed. The patient was hospitalized, and nasogastric decompression was initiated. On hospitalization day 3, she developed shock, and her respiratory state deteriorated, requiring intubation and mechanical ventilation. Nasogastric decompression contributed to the improvement in her clinical condition. She was discharged 3 mo after admission. During outpatient follow-up, her dietary intake decreased, and her body weight gradually decreased by 14 kg. An upper gastrointestinal series and endoscopy revealed pyloric stenosis; therefore, we performed gastrojejunostomy 18 mo after her initial admission. The patient was discharged from the hospital with no postoperative complications. Gastric necrosis and perforation due to overeating-induced gastric dilatation are life-threatening conditions. Surgical intervention may be required if delayed pyloric stenosis occurs after conservative treatment. We report a case of pyloric stenosis due to overeating-induced gastric dilatation treated by gastrojejunostomy 18 mo after the initial presentation.
Core tip: Acute gastric dilatation due to overeating may be life-threatening if gastric necrosis or perforation occurs. Therefore, emergency surgery is performed in most cases. This is the first report of a patient who underwent surgery more than a year after initial treatment. The number of patients with eating disorders, such as bulimia, has recently increased. For this reason in particular, physicians should be aware of acute gastric dilatation due to overeating.
