title: Death due to duodenal obstruction in a patient with an eating disorder: a case report.
abstract: OBJECTIVE
  A 30-year-old woman with a 2-year history of bulimia nervosa and severe abdominal pain after excessive food consumption visited our emergency room. Her abdomen showed marked generalized distension.
  
  
  METHODS
  Aspiration of the gastric contents was not successful, and despite efforts to resuscitate her, the patient died.
  
  
  RESULTS
  An autopsy showed a markedly distended stomach containing approximately 6,500 ml of solid foods. The aortomesenteric distance was <1.0 cm and the aortomesenteric angle was <20 degrees, suggesting superior mesenteric artery (SMA) syndrome may have been a cause of death.
  
  
  CONCLUSIONS
  However, her condition was also consistent with duodenal obstruction due to a heavy stomach and high intra-abdominal pressure, and her cause of death was diagnosed as intestinal obstruction due to an excessive volume of food.
authors.affiliation: Department of Forensic Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. ikegaya-tky@umin.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ikegaya
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakajima
authors.forename: Kaori
authors.initials: K
authors.lastname: Shintani-Ishida
authors.forename: Koichi
authors.initials: K
authors.lastname: Uemura
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D052018:Bulimia Nervosa / Q000150:complications*; D004380:Duodenal Obstruction / Q000209:etiology* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans