Acute massive gastric dilatation with necrosis and portal vein gas accumulation—a case report
By
Xiaoxu He
Jun Wang
Yongjiang Zhao
Shumin Ma
Zhiping Wang
Bo Chen
Yongliang Yao
June 19, 2026
Clinical Scorecard: Case Study of Severe Acute Gastric Distension with Ischemic Necrosis and Portal Vein Gas Formation
At a Glance
Category Detail
Condition Acute Gastric Distension (AGD) Key Mechanisms Ischemic necrosis, perforation, gas accumulation in the portal vein Target Population Individuals experiencing acute binge eating episodes Care Setting Emergency and surgical care
Key Highlights
AGD can lead to ischemic necrosis and high mortality rates (80-100%) Early diagnosis via CT is critical for management Emergency laparotomy is necessary for severe cases Portal vein gas is a warning sign of mucosal necrosis Patients can recover well with prompt surgical intervention Guideline-Based Recommendations
Diagnosis
Use abdominal CT scans for diagnosis of AGD Management
Emergency laparotomy for severe cases with necrosis Monitoring & Follow-up
ICU monitoring for septic shock and vital signs post-surgery Risks
High mortality rates associated with delayed treatment Patient & Prescribing Data
15-year-old male with no prior psychiatric disorders
Postoperative care included norepinephrine and antibiotics for septic shock
Clinical Best Practices
Recognize signs of AGD in patients with acute abdominal pain and distension Monitor for signs of septic shock in AGD patients Implement prompt surgical decompression in cases of severe AGD Related Resources & Content
