Massive gastric distension from excessive food ingestion

T Kajiya¹, K Shiki¹, T Asano¹, K Omori¹, Y Natsume¹, S Sakurai¹, C Tei²,  
¹ Department of General Internal Medicine, Oshima Medical Association Hospital, Kagoshima, Japan
² Department of Cardiovascular, Respiratory and Metabolic Medicine, Kagoshima University Hospital, Japan

Correspondence Address:
T Kajiya
Department of General Internal Medicine, Oshima Medical Association Hospital, Kagoshima
Japan

Full Text

A 47-year-old man with a history of traumatic acute subdural hematoma as well as atypical psychosis was cared for in a nursing home. His sister, who was treated for schizophrenia at a psychiatry clinic, visited him at the home, giving him food and drink including about 1.5kg of rice, 1kg of sweet potatoes, two packages of snacks and two liters of soft drinks. Two hours later he began to vomit and complained of abdominal pain. Upon hospitalization, abdominal radiography disclosed massive gastric distension [Figure 1]. Computed tomography showed no sign of bowel obstruction. After treatment with an ileus tube and intravenous fluids for 1month his stomach had shrunk to a normal size. Patients who have a history of psychiatric disease may ingest incredible amounts of food, leading to massive gastric distention. [1] There are many underlying diseases which are known to cause gastric distention, such as tumors and ileus. However, gastric distention due to food itself is uncommon. The gastric capacity of bulimic patients is larger than that of normal people. [2] However, when the amount of food ingested exceeds gastric capacity, it could be lethal. [3] Conservative therapy may be acceptable, but such patients should be monitored carefully and should remain hospitalized.

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