Acute massive gastric dilatation with necrosis and portal vein gas accumulation—a case report

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Acute gastric distension (AGD) can lead to ischemic necrosis, perforation, and gas accumulation in the portal vein, with mortality rates as high as 80–100%.
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A 15-year-old male developed severe AGD after binge eating, presenting with abdominal pain, bloating, and vomiting, and was diagnosed via abdominal CT.
3

Emergency laparotomy revealed extensive gastric distension and hemorrhagic necrosis, requiring gastric decompression and necrotic area debridement.
4

The patient experienced septic shock post-surgery but stabilized after intensive care and was discharged in stable condition 14 days later.
5

Portal air is a critical indicator of mucosal necrosis, emphasizing the need for early diagnosis and prompt surgical intervention in AGD cases.

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