A CASE OF SPONTANEOUS RUPTURE OF THE STOMACH IN AN ADULT WITH PYLORIC STENOSIS

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  • 幽門狭窄に生じた成人胃破裂の１例

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Abstract

A 75-year-old man was admitted to our facility with the sudden onset of severe abdominal pain and fullness, which occurred accompanied by repeated vomiting. He had a history of appetite loss and tarry stool one month prior to admission. Abdominal CT scan showed massive free air and fluid collection in the abdominal cavity. Upper gastrointestinal endoscopy disclosed pyloric stenosis due to gastric ulcer. An emergency operation was performed under the suspicious diagnosis of perforative gastric ulcer. At laparotomy, however, no perforation could be seen at the site of the gastric ulcer, but an approximately 3-cm longitudinal tear was observed at the lesser curvature of the stomach. The lesion was sutured primarily in two layers, and a distal resection of the stomach including the ulcer with Billroth II anastomosis was made. It was presumed that the excessive increased intragastric pressure, which was induced by frequent vomiting in pyloric stenosis, caused the rupture of the stomach.

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