Acute gastric necrosis in anorexia nervosa and bulimia. Two case reports

In recent years we have treated two patients with gastric infarction as a complication of anorexia nervosa and bulimia. We found only three other cases reported in the literature. Surgical intervention was delayed in all five patients either because the diagnosis was missed by the physician or because the patient failed to seek medical attention. Physicians should be alerted to the possibility of acute gastric dilatation if a young woman, who may be undernourished and anorexic, complains of abdominal pain after ingestion of a large meal. Often this condition can be treated conservatively before irreversible damage to the gastric wall has taken place. If the gastric dilatation progresses, the stomach loses its contractility, resulting in venous occlusion, infarction, and gastric perforation. An extensive operation is required, and the patient undergoes an often complicated and prolonged hospital course.