Spontaneous Gastric Rupture triggered Overextension due to Excessive Oral Intake following Distal Gastrectomy: A Case Report

Koji Ohta, Akira Kurita, Minoru Tanada, Takaya Kobatake, Isao Nozaki, Yoshirou Kubo and Shigemitsu Takashima

Department of Digestive Surgery, Shikoku Cancer Center

We report a case of spontaneous gastric rupture following distal gastrectomy. A 67-year-old man who underwent distal gastrectomy for gastric cancer and discharged our hospital on postoperative day (POD) 14, ate a large amount of sushi, then experienced severe enough gastric pain to be admitted in an emergency. Physical examination showed muscular defense in the upper abdomen. Computed tomography (CT) showed abdominal free air and ascites, necessitating emergency surgery for acute abdomen. Laparotomy findings included turbid ascites and numerous grain of rice in the upper abdomen. The upper gastric body had a 3-cm longitudinal tear at the greater curvature. Neither ulceration nor inflammation was seen, and diagnosing spontaneous gastric rupture, we sutured the lesion primarily in two layers and lavaged and drainaged the abdomen. No stenosis had been seen in X-ray imaging at the gastrojejunostomy on POD 14, so we concluded that excessive oral intake had overextended the stomach, triggering spontaneous gastric rupture.

Key words
spontaneous gastric rupture, distal gastrectomy, complication

Reprint requests
Koji Ohta Department of Digestive Surgery, Shikoku Cancer Center
160 Minamiumenomoto-machi Kou, Matsuyama, 791-0280 JAPAN

Accepted
September 24, 2008

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