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Gastric Rupture

Ruptures Stomach


Presentation

  • Inguinoscrotal gastric herniation is a rare occurrence and generally presents with obstruction when encountered.[ncbi.nlm.nih.gov]
  • This report presents a unique case of gastric rupture and illustrates the factors necessary for prompt recognition and treatment.[ncbi.nlm.nih.gov]
  • We present a recent case of a young woman submitted to cardiopulmonary resuscitation in whom a gastric rupture gave rise to massive pneumoperitoneum with haemodynamic shock and respiratory failure.[ncbi.nlm.nih.gov]
  • Gastric rupture is an uncommon surgical problem which normally presents with an acute abdomen and peritonism. An unusual case following underwater ascent and its conservative management is presented.[ncbi.nlm.nih.gov]
  • This report describes the presentation, treatment, and prevention of this entity.[ncbi.nlm.nih.gov]
Cerebral Palsy
  • Children with cerebral palsy (CP) develop difficulties with swallowing and bowel motility, although the underlying etiology of these disorders is unclear.[ncbi.nlm.nih.gov]
Abdominal Pain
  • Vomiting and abdominal pain, although rare in PWS, were frequent findings in this cohort. The physician should consider an emergent evaluation for gastric rupture and necrosis in individuals with PWS who present with vomiting and abdominal pain.[ncbi.nlm.nih.gov]
  • We report a 37-year-old primigravida with a gastric band who developed the clinical picture of abdominal pain, vomiting and regurgitation coexistent with a cardiotocogram with severe variable decelerations with absent variability at 33 weeks' gestation[ncbi.nlm.nih.gov]
  • Sharp abdominal pain was present immediately after surfacing and afterwards. Full abdominal distension developed within two hours after the ascent. No other diving-related pathology was found.[ncbi.nlm.nih.gov]
  • Abdominal pain or persistent abdominal distention despite nasogastric suction after the Heimlich maneuver should prompt evaluation for possible gastric rupture.[ncbi.nlm.nih.gov]
  • Both patients exhibited symptoms of abdominal pain and distension following oxygen delivery involving a nasopharyngeal catheter during procedural sedation. Oxygen flow rates were 4 l/minute in both cases. The diagnosis was made by urgent imaging.[ncbi.nlm.nih.gov]
Abdominal Distension
  • The clinical manifestations include severe abdominal distension, vomiting, and respiratory distress. However, diagnosis is based on an upright x-ray film of the abdomen which shows the "saddle" of "football" sign due to massive pneumoperitoneum.[ncbi.nlm.nih.gov]
  • Although very few cases have been reported in which the esophagus has inadvertently been intubated resulting in gastric perforation, this is a potential possibility and should be borne in mind when intubation is followed by abdominal distension, rigidity[ncbi.nlm.nih.gov]
  • This case reports on idiopathic gastric rupture in a 3-mo-old girl who had frequent episodes of vomiting and abdominal distension the day before admission to the clinic.[ncbi.nlm.nih.gov]
  • Full abdominal distension developed within two hours after the ascent. No other diving-related pathology was found.[ncbi.nlm.nih.gov]
  • Although abdominal distension was noticed during the physical examination, muscular rigidity was not detected on palpation. Laboratory data showed severe hypotonic dehydration and moderate metabolic acidosis with hyperkalemia.[ncbi.nlm.nih.gov]
Severe Abdominal Pain
  • abdominal pain (2) free air within the abdomen (3) diffuse peritonitis (4) shock (5) hole or tear in the gastric wall, with leakage of oral radiocontrast material (6) subcutaneous emphysema (if due to gastric inflation) Exclusion - Differential diagnosis[meducator3.net]
  • In the unit, the patient became irritable and severe abdominal pain was noted. A semi-erect chest X-ray ( Fig. 1 ) revealed a massive pneumoperitoneum. Emergency laparotomy was performed for suspected perforated hollow viscus.[academic.oup.com]
  • Gastrointestinal perforation results in severe abdominal pain intensified by movement, nausea, vomiting and hematemesis. Later symptoms include fever and or chills. [6] In any case, the abdomen becomes rigid with tenderness and rebound tenderness.[en.wikipedia.org]
  • Usually follows gastric dilatation severe abdominal pain dramatic tachycardia gastric rupture along greater curvature sudden relief of pain endotoxic and hypovolemic shock cardiovascular collapse death.[vetstream.com]
Epigastric Pain
  • The patient was admitted to a neighboring hospital because of vertigo with 1-day history of intractable vomiting and epigastric pain.[ncbi.nlm.nih.gov]
  • He reported epigastric pain and his upper abdomen was tender, with guarding. The child was cooperative and did not carry any other major wounds. No pain could be elicited in the thorax, the pelvis, or other areas of the body.[panafrican-med-journal.com]
  • On full awakening in the recovery room, the patient complained of severe epigastric pain. On examination, her abdomen was rigid and markedly distended, with guarding and rebound tenderness present.[anesthesiology.pubs.asahq.org]
Abdominal Tenderness
  • The majority of patients with gastric rupture will present with signs of shock or abdominal tenderness.[freethesaurus.com]
Hypotension
  • The patient was intubated and a noradrenaline infusion started due to marked hypotension, unresponsive to fluids. Imaging studies revealed a left pulmonary atelectasis and a massive pneumoperitoneum.[omicsonline.org]
  • Back to Top Low Blood Pressure (Also Known As Hypotension) Dangerously low blood pressure can cause you to have an abnormal heart rate, shock (that can lead to organ failure) or even cardiac arrest.[your-bulimia-recovery.com]

Workup

Pneumoperitoneum
  • Gastric rupture with resulting tension pneumoperitoneum occurs rarely in infants. It may be associated with resuscitative efforts.[ncbi.nlm.nih.gov]
  • In cases of vigorous mouth-to-mouth ventilation, bag-valve-mask ventilation, or esophageal intubation, gastric rupture and massive intraperitoneal free air may cause tension pneumoperitoneum.[ncbi.nlm.nih.gov]
  • We report a case of a much rarer complication: gastric rupture with pneumoperitoneum. Prompt recognition and surgical intervention help minimize adverse outcomes from complications such as tension pneumoperitoneum with shock, peritonitis, and sepsis.[ncbi.nlm.nih.gov]
  • Tension pneumoperitoneum occurred with acute respiratory distress. Gastric rupture occurring during cardio-pulmonary resuscitation has been reported several times. Our case illustrates another unusual cause of tension pneumoperitoneum.[ncbi.nlm.nih.gov]
  • Inadvertent esophageal intubation during cardiopulmonary resuscitation following aortocoronary bypass grafting resulted in gastric rupture and tension pneumoperitoneum in a 65-year-old patient.[ncbi.nlm.nih.gov]
Gastric Fistula
  • Most complications are a result of the massive intraperitoneal contamination that ensues after rupture of a distended stomach and usually account for the late mortality. 1,2 The most common complications are intra-abdominal abscess, gastric fistula formation[appliedradiology.com]
Pancreatic Necrosis
  • Figure 3: Endoscopic ultrasound: Walled-off pancreatic necrosis breaching the gastric wall (white arrows) Click here to view Figure 4: Contrast enhanced computed tomography: Walled-off pancreatic necrosis breaching the gastric wall (arrows) Click here[jdeonline.in]

Treatment

  • The following associated characteristics were analysed: mechanism of injury, clinical presentation, possible associated injuries and postoperative complications, diagnosis methods and surgical treatment.[ncbi.nlm.nih.gov]
  • This report describes the presentation, treatment, and prevention of this entity.[ncbi.nlm.nih.gov]
  • This report presents a unique case of gastric rupture and illustrates the factors necessary for prompt recognition and treatment.[ncbi.nlm.nih.gov]
  • The aggressive operative treatment of these patients is emphasized along with the vigorous attention that must be given to postoperative intra-abdominal sepsis caused by the initial contamination leading to morbidity and mortality.[ncbi.nlm.nih.gov]
  • Awareness of this unusual complication may lead to early recognition and successful treatment.[ncbi.nlm.nih.gov]

Prognosis

  • Since clinical condition of gastric rupture deteriorates rapidly, early diagnosis and appropriate treatment is essential for good prognosis. One should consider that ulcer formation might cause gastric rupture in childhood.[ncbi.nlm.nih.gov]
  • Prognosis : grave to hopeless.[vetstream.com]
  • The prognosis can be poor, especially if diagnosis is delayed. We suggest the early CT scan intervention is more helpful and necessary if SB tube related esophageal rupture is suspected. C. T. Lin, T. W. Huang, S. C. Lee, S. M. Kuo, K. F. Hsu, P. S.[scielo.isciii.es]
  • […] colon cancer, diverticulitis, stomach ulcers, ischemic bowel, C. difficile infection [2] Diagnostic method CT scan, plain X-ray [2] Treatment Emergency surgery in the form of an exploratory laparotomy [2] Medication Intravenous fluids, antibiotics [2] Prognosis[en.wikipedia.org]

Etiology

  • Children with cerebral palsy (CP) develop difficulties with swallowing and bowel motility, although the underlying etiology of these disorders is unclear.[ncbi.nlm.nih.gov]
  • Current opinions regarding the possible etiology is included in the discussion. Neonatal asphyxia was the most commonly seen predisposing cause in our series (63%). Roentgenograms of the abdomen are most helpful in making a positive diagnosis.[ncbi.nlm.nih.gov]
  • Case Report - Current Pediatric Research (2016) Volume 0, Issue 0 Gastric rupture is extremely rare in childhood beyond the neonatal period and the etiology of this condition in preschool children remains obscure.[alliedacademies.org]
  • The etiology, pathology, clinical manifestations and experiences in 3 children with GRAGD were reviewed. Case 1: After diagnosing GRAGD and stabilizing her shock with massive fluid replacement, gastrostomy was performed.[ncbi.nlm.nih.gov]
  • Kneiszl F: Some data on the etiology of gastric rupture in the newborn. Biol Neonat 4:201, 1962 Google Scholar 17. Shaw A, Blanc WA, Santulli TV, et al: Spontaneous rupture of the stomach in the newborn. A clinical and experimental study.[link.springer.com]

Epidemiology

  • Timecourse Duration of clinical signs before rupture varies from Epidemiology Prevalence of gastric rupture 1-6% in post-mortem surveys; 5-8% in cases of colic.[vetstream.com]
Sex distribution
Age distribution

Pathophysiology

  • We review the literature and discuss ECT and potential risk factors relevant to the pathophysiology of gastric rupture. Furthermore, recommendations are proposed for clinical management.[ncbi.nlm.nih.gov]
  • Additional pathophysiology content helps you better understand the effects of diseases and injuries on the body’s normal physiologic processes.[books.google.com]
  • Pathophysiology Usually follows gastric distension.[vetstream.com]

Prevention

  • This report describes the presentation, treatment, and prevention of this entity.[ncbi.nlm.nih.gov]
  • I think, sudden gastric rupture can be prevented by physically decompressing the area. Anaesthesia and analgesics should be avoided since they cause the stomach muscles to relax, thus counteracting the decompression.[myproana.com]
  • […] lay person is much more likely to cause significant gastric inflation than ventilation with an LMA: during mouth-to-mouth or bag-valve-mask ventilation, incorrect alignment of the airway will cause gastric inflation because the mask or rescuer’s mouth prevents[bmj.com]
  • Gastric dilatation alters the gastro-esophageal angle and prevents the exit of gas into the esophagus [ 4, 14 ]. Pressures from 120 to 150 mmHg are required to perforate the normal gastric wall [ 2 ].[omicsonline.org]
  • […] cardia and pylorus are sites of potential decompression because of fixation by the hepatogastric ligament, 10 different degrees of gastric distension (along the lesser and major curvatures) may change the anatomy and configuration of the stomach to prevent[academic.oup.com]

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