Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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Gastric Pneumatosis and Its Gastrofibroscopic Findings in Life-Threatening Superior Mesenteric Artery Syndrome Complicated by Anorexia Nervosa in a Child

  • Jeong Ho Seo (Department of Pediatrics, Hanyang University College of Medicine) ;
  • Inwook Lee (Department of Pediatrics, Hanyang University College of Medicine) ;
  • Saehan Choi (Department of Pediatrics, Hanyang University College of Medicine) ;
  • Seung Yang (Department of Pediatrics, Hanyang University College of Medicine) ;
  • Yong Joo Kim (Department of Pediatrics, Hanyang University College of Medicine)
  • Received : 2023.05.23
  • Accepted : 2023.07.23
  • Published : 2023.09.15
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Abstract

A 14-year-old girl was admitted to the emergency department for excessive bile-containing vomiting and severe abdominal pain. She had been healthy until she intentionally lost 25 kg over a 6-month period. Thick, bloody bile-mixed food particles were drained from the stomach through a nasogastric tube. Abdominal computed tomography revealed huge stomach dilatation with extensive gastric pneumatosis, possible near rupture, acute pancreatitis, and a very narrow third of the duodenum, indicating superior mesenteric syndrome. Gastrofibroscopy revealed multiple hemorrhagic ulcers and numerous beadlike cystic lesions in the stomach. Laboratory examination results were notable for severe deficiencies in critical nutrients, including iron, zinc, proteins, and prealbumin, as well as undernutrition-associated endocrine complications such as hypothyroidism and hypogonadotropic hypogonadism. Excessive vomiting ceased after the endoscopic removal of stagnant gastric contents. Gastric pneumatosis improved after 3 days of supportive care.

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References

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