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KMID : 1038820230260050284
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Pediatric Gastroenterology, Hepatology & Nutrition
2023 Volume.26 No. 5 p.284 ~ p.289
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Gastric Pneumatosis and Its Gastrofibroscopic Findings in Life- Threatening Superior Mesenteric Artery Syndrome Complicated by Anorexia Nervosa in a Child
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Seo Jeong-Ho
Lee In-Wook
Choi Sae-Han
Yang Seung
Kim Yong-Joo
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Abstract
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A 14-year-old girl was admitted to the emergency department for excessive bile-containing vomiting and severe abdominal pain. She had been healthy until she intentionally lost 25 kg over a 6-month period. Thick, bloody bile-mixed food particles were drained from the stomach through a nasogastric tube. Abdominal computed tomography revealed huge stomach dilatation with extensive gastric pneumatosis, possible near rupture, acute pancreatitis, and a very narrow third of the duodenum, indicating superior mesenteric syndrome. Gastrofibroscopy revealed multiple hemorrhagic ulcers and numerous beadlike cystic lesions in the stomach. Laboratory examination results were notable for severe deficiencies in critical nutrients, including iron, zinc, proteins, and prealbumin, as well as undernutrition-associated endocrine complications such as hypothyroidism and hypogonadotropic hypogonadism. Excessive vomiting ceased after the endoscopic removal of stagnant gastric contents. Gastric pneumatosis improved after 3 days of supportive care.
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KEYWORD
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Gastric dilatation, Superior mesenteric artery syndrome, Anorexia nervosa, Malnutrition, Child
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