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A Rare Case of Acute Gastric Dilatation With Gastric Wall Necrosis Without Perforation - Case Report

Arunkumar N R .

Abstract


Acute gastric dilatation can have multiple etiologies which may lead to ischemia and necrosis of the stomach. Without proper timely diagnosis and treatment, potentially fatal events such as gastric perforation, haemorrhage, and other serious complications can occur. Here we present a 50-year-old man who came to the casualty with pain abdomen and distension for 3 days. Clinically, abdomen was distended with diffuse tenderness and rigidity. X-ray abdomen showed  fundal air shadow without any Air under Diaphragm. Ultrasound Abdomen revealed mild free fluid in Abdomen and Pelvis with internal echoes and two hyperechoeic foci (? Air pockets) with an impression of ? Perforative Peritonitis. Emergency Exploratory Laparotomy revealed grossly dilated stomach with multiple patchy necrotic sloughed out lesions in Anterior stomach wall over greater curvature and fundus involving serosa with impending perforation. About 50ml of serosanguinous fluid was noted in pelvis. Thorough peritoneal lavage with Feeding jejunostomy was done. The patient recovered well and was discharged on the tenth postoperative day.


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