[Spontaneous ventricular rupture in adults]

Since 1928, 60 cases of spontaneous gastric rupture have been described. One third of these cases were seen after vomiting, and two thirds were associated with gastric dilatation after a big meal, of which one third were combined with an intake of antacids. In five cases the patients were suffering from anorexia nervosa. Besides the above mentioned causes, gastric atrophy, "closed-loop" obstruction and postoperative atony are possible pathogenetic factors. Most often the ruptures are located to the lesser curvature. In the period before the rupture associated with dilatation takes place, the patient typically complains of abdominal pain and the abdomen is found asymmetrically distended. After rupture of the stomach the patient is found with very aggressive pain and in shock. The abdomen has become more symmetrically distended and most often free air within the abdominal cavity can be diagnosed on X-ray. The treatment consists of resection of the necrotic area of the stomach, and as the intensive care of the patients both before, during and after surgery has reached a very high priority and standard, the mortality has been reduced from 75% to 30%.