ACUTE GASTRIC DILATATION WITH SUPERIOR ME SENTERIC-ARTERY SYNDROME INA GIRL WITH ANOREXIA-NERVOSA

Background. - Acute gastric dilatation is a rare complication of anore xia nervosa which may be fatal in case of gastric perforation. Superio r mesenteric artery syndrome may be associated with gastric dilatation . Case report. - A 14 year-old girl was admitted suffering from severe anorexia nervosa, Shortly after admission, she complained of abdomina l pain related to a bulimic episode a few days before, followed by nau sea and vomiting. Distended abdomen and tachycardia suggested acute sm all-bowel obstruction. A diagnosis of acute gastric dilatation with su perior mesenteric artery syndrome was suspected on X-ray examination a nd confirmed by esophagogastrography after gastric evacuation. The pat ient improved rapidly under total parenteral nutrition, Upper gastroin testinal study repeated 10 days Eater showed normal stomach. Conclusio ns. - Small-bowel obstruction in anorexia nervosa first evokes acute g astric dilatation, and a perforation has to be ruled out by esophagoga strography. Association with superior mesenteric artery syndrome is po ssible; it does not necessarily lead to surgery.