CASE REPORTS   

Chirurgia 2013 April;26(2):151-3

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Gastric lesser curve necrosis: a case report

Maternini M., Fattori L., Orsolini M., Calcinati S., Degrate L., Romano F., Nespoli L., Uggeri F.

General and Emergency Surgery Department, University of Milano-Bicocca, San Gerardo Hospital, Monza, Monza-Brianza, Italy

Many causes have been described for acute gastric necrosis, however it still a very rare condition. A 60 year old female complaining of abdominal pain, nausea and vomiting arrived at our attention. On physical examination, the abdomen was severely distended and presented tenderness with muscle guarding. Plain radiography and a CT scan revealed marked gastric distension with pneumoperitoneum and free fluid. Intraoperative findings revealed a large zone of necrosis along the lesser curvature. The reported causes are various including volvolous, intrathoracic hernia, acute necrotizing gastritis, acute gastric dilatation and vascular compromise. Detention with nasogastric tube and fluid resuscitation is mandatory, followed by surgery in case of perforation. Gastric distension, perforation with peritonitis is a relatively contraindication to a laparoscopic approach. In our experience, we think, may be an approach reserved to referral laparoscopic centers. The extension of the resection is releated to the patient’s condition and to the extension of the necrosis.