An unusual case of massive gastric distension with catastrophic sequelae.
We report a case of massive gastric distension presenting with abdominal pain, shock and lower limb ischaemia. At laparotomy, gastric distension was found to be secondary to gastric outflow obstruction compounded by gas formation from antacid ingestion. Both the aorta and inferior vena cava were directly compressed by the distended stomach. This mode of presentation and combined aetiologies remain unreported. Gastric decompression resulted in profound cardiovascular compromise, multiorgan failure and eventually death.
Lewis
S
S
Department of Anaesthetics, Royal United Hospital, Bath, UK. slewis@talk21.com
Holbrook
A
A
Hersch
P
P
D015746:Abdominal Pain / Q000209:etiology; D000863:Antacids / Q000009:adverse effects; D001018:Aortic Diseases / Q000209:etiology; D001784:Blood Gas Analysis; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology; D017809:Fatal Outcome; D005260:Female; D005355:Fibrosis; D013271:Gastric Dilatation / Q000150:complications / Q000628:therapy*; D017219:Gastric Outlet Obstruction / Q000150:complications; D006801:Humans; D007813:Laparotomy; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D010437:Peptic Ulcer / Q000150:complications; D013479:Superior Vena Cava Syndrome / Q000209:etiology
D000863:Antacids