ACUTE GASTRIC DILATATION IN DUCHENNE MUSCULAR-DYSTROPHY - A CASE-REPORT AND REVIEW OF THE LITERATURE

Duchenne muscular dystropby (DMD) is the most common neuromuscular dis order of childhood. Its clinical characteristics that derive from skel etal muscle involvement have been well described. Less well known is t hat visceral smooth muscle is affected in DMD. We report a case of a 1 9-year-old man with DMD who presented with severe nonradiating epigast ric pain. We was initially sent home from the emergency department wit h a diagnosis of costochondritis. Acute gastric dilation was not consi dered in the differential diagnosis despite supportive history, physic al examination findings, and radiographs. The case illustrates the lac k of familiarity by clinicians of the gastrointestinal manifestations of DMD, including gastric dilatation and intestinal pseudoobstruction. Following a case discussion, the literature relevant to acute gastric atony is reviewed. (C) 1996 by the American Congress of Rehabilitatio n Medicinal and the American Academy of Physical Medicine and Rehabili tation