[Acute abdominal dilatation, a serious complication in the case of anorexia nervosa].
BACKGROUND
The prognosis of anorexia nervosa (AN) is severe (death in 2 to 5% of cases). AN is closely linked to episodes of bulimia.


METHODS
A 25 year-old woman suffering from anorexia nervosa was hospitalised for an occlusive syndrome with vomiting, presence of abdominal cramps, absence of hydroaeric sounds and suspension of stools and gas. The biological examinations were normal. The abdominal scan revealed voluminous gastric dilatation. The diagnosis of functional occlusive syndrome was retained. With medical treatment and follow-up in intensive care the gastric dilatation progressively regressed.


CONCLUSIONS
The periods of restricted nourishment during NA are interspaced by episodes of bulimia and at the origin of sometimes severe digestive complications. The abnormalities in gastric motility can lead to major dilatation of the stomach with the risk of perforation. The onset of abdominal pain in the context of AN during an episode of bulimia must evoke the diagnosis of acute gastric dilatation with major risk of perforation.
Mathevon
T
T
Service accueil des urgences, Hôpital Gabriel Montpied, Clermont-Ferrand. tmathevon@chu-clermontferrand.fr
Rougier
C
C
Ducher
E
E
Pic
D
D
Garcier
J-M
JM
Schmidt
J
J
D015746:Abdominal Pain / Q000209:etiology; D000208:Acute Disease; D000328:Adult; D000856:Anorexia Nervosa / Q000150:complications* / Q000188:drug therapy; D000928:Antidepressive Agents / Q000627:therapeutic use; D002032:Bulimia / Q000150:complications* / Q000188:drug therapy; D005260:Female; D013271:Gastric Dilatation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005769:Gastrointestinal Motility; D005773:Gastroscopy; D006801:Humans; D007441:Intubation, Gastrointestinal; D011379:Prognosis; D054328:Proton Pump Inhibitors; D012017:Referral and Consultation; D012307:Risk Factors; D012422:Rupture, Spontaneous; D013275:Stomach Rupture / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology
D000928:Antidepressive Agents; D054328:Proton Pump Inhibitors