Gastric perforation secondary to acute gastric dilatation, case report

Year 2010, Volume: 41 Issue: 2, 107 - 109, 01.03.2010

Osman Z. Karakuş Çiğdem Atılğan

Abstract

Objective: Acute gastric dilatation (AGD) and gastric perforation are extremely rare conditions in childhood. Psychogenic polyphagia, peptic ulcer, trauma of resuscitation, electrolyte abnormalities, volvulus and many other reasons may play a role in the etiology of the AGD. Gastric decompression and urgent surgical intervention reduce mortality. Case Report: A case of 14 years old boy who presented with complaints of abdominal pain and vomiting that diagnosed gastric perforation was reported. The patient who suffered with abdominal pain and vomiting due to over-eating after fasting, mild abdominal distension and peritoneal irritation findings were detected in the physical examination and free air was found at plain abdominal radiography. Primary repair was performed by excision of necrotic and ruptured area that is detected in the emergency laparotomy. The patient was discharged with no postoperative complications. Conclusions: Early diagnosis and urgent surgical intervention in spontaneous gastric perforation due to acute gastric dilatation is life saving.

Keywords

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Akut gastrik dilatasyona bağlı mide perforasyonu, olgu sunumu

Abstract

Giriş: Akut mide dilatasyonu (AMD) ve mide perforasyonu çocukluk çağında oldukça nadir görülen bir durumdur. AMD etiyolojisinde aşırı yeme, peptik ülser, travma resusitasyonu, elektrolit bozuklukları, volvulus ve pek çok başka sebep rol oynayabilir. Mide dekompresyonu uygulanması ve perforasyon varlığında acil cerrahi girişim mortaliteyi azaltır. Olgu Sunumu: Yazımızda 14 yaşında mide perforasyonu tespit edilen bir hastanın olgu sunumu yapılmaktadır. Oruç sonrası fazla yemeye bağlı karın ağrısı ve kusma şikayetleri ile başvuran hastada hafif batın distansiyonu, periton irritasyon bulguları, direkt batın grafısinde serbest hava gölgesi saptandı. Acil laparotomi uygulanan hastada midede nekroze ve rüptüre alan eksize edilerek primer onarım uygulandı. Postoperatif komplikasyon gelişmeyen hasta taburcu edildi. Sonuç: Akut mide dilatasyonuna bağlı spontan mide perforasyonunda erken tanı ve hızlı cerrahi müdahale hayat kurtarıcıdır.

Keywords

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