A Case of Spontaneous Rupture of the Stomach in the Adult

Shuichi Murata, Hidenori Maruoka, Katsumi Kiyosaki, Rin-ichiro Wakasa, Tomohiko Ikeya, Atsuo Hirose, Satoshi Ushijima

Department of Surgery, Himi Municipal Hospital

The following was our clinical experience with a patient with spontaneous rupture of the stomach probably induced by overdistention of the stomach resulting from a large pool of blood during treatment of a hemorrhagic gastric ulcer. A 72-year-old woman was admitted to our facility because of hematemesis. An endoscopic examination of the stomach revealed a large quantity of blood in the stomach. The source of the hemorrhage, however, could not be identified. About 48 hr after admission, the patient had severe hematemesis again, resulting in shock. At laparotomy, 3.2 liters of blood was removed from the abdominal cavity and about 15-cm longitudinal tear was observed at the lesser curvature of the stomach. An ulcer on the posterior wall of the corpus of the stomach adhered to the spleen and the tail of the pancreas. Therefore, total gastrectomy combined with splenectomy and resection of the tail of the pancreas was performed. Histological examination revealed a 4.5×2 -cm Ul-IV ulcer on the posterior wall of the corpus of the stomach, with rupture of an artery at the site of the ulcer. It was presumed that in the stomach inflated with blood, hematemesis caused the intragastric pressure to increase drastically, causing the lesser curvature to rupture. This case is the third documented adult case of spontaneous rupture of the stomach in Japan.

Key words
spontaneous rupture of the stomach

Reprint requests
Shuichi Murata Department of Surgery, Himi Municipal Hospital
31-9 Saiswai-cho, Himi, 935 JAPAN

Accepted
February 10, 1993

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