Gastric outlet obstruction masquerading as anorexia nervosa

Area of Science:

• Gastroenterology
• Psychiatry
• Internal Medicine

Background:

• Anorexia nervosa is an eating disorder characterized by self-starvation and distorted body image.
• Late-onset anorexia nervosa is rare and can present with atypical features, posing diagnostic challenges.
• Peptic ulcer disease can lead to gastric outlet obstruction, causing significant weight loss and gastrointestinal symptoms.

Purpose of the Study:

• To investigate a case of apparent late-onset anorexia nervosa in a Chinese patient.
• To differentiate between anorexia nervosa and other conditions with similar presentations.
• To highlight the importance of considering organic causes in atypical eating disorder cases.

Main Methods:

• Case report of a 30-year-old Chinese housewife.
• Clinical evaluation, diagnostic workup for eating disorders and gastrointestinal pathology.
• Surgical intervention for gastric outlet obstruction.

Main Results:

• The patient presented with symptoms suggestive of anorexia nervosa.
• Diagnostic workup revealed peptic ulcer disease complicated by gastric outlet obstruction.
• Surgical treatment resulted in rapid body weight improvement.
• Immature personality traits persisted post-surgery.

Conclusions:

• Atypical presentations of anorexia nervosa require careful consideration of underlying organic diseases.
• Peptic ulcer disease with gastric outlet obstruction can mimic anorexia nervosa.
• Surgical management can resolve physical symptoms but may not address psychological aspects of personality.