I had chills and extreme pain after I ate and often ran a low grade fever. The pain after this surgery grew worse instead of better. In hindsight, what happened over the next several weeks should have been our alert. I was discharged from the hospital 10 days later when my bowels ‘woke up’ from surgery and all systems seemed to be functioning. When I awoke from surgery, the report was that all went well. No real explanation was given, but the solution was emergency surgery to cut out the blocked part of the intestines and put me back together. My husband rushed me to the ER where a cat-scan revealed a kink in my intestines. I made my way to the bathroom floor with intense abdominal pain that took my breath away. One week later I woke up in the middle of the night in excruciating pain. At 38, I was in the best shape of my life. January 12, 2013, I ran the Disney half marathon. March 13, 2013, my body went into septic shock. Many patients are reluctant to disclose their condition, so radiological findings have a central role in identifying undiagnosed eating disorders. Recognition of such complications is critical to effective patient care, and requires a radiologist to be aware of the spectrum of imaging abnormalities that may be seen. The patient underwent a complete detailed psychiatric evaluation for conclusive diagnostic definition. The early stage of the eating disorder or an oral “obsessive” care may have been the explanation of the absence of these pathognomonic aspects. Furthermore, a repeated careful examination did not reveal any dental changes: there was no erosion of tooth enamel, nor small hemorrhages of palate, nor gland salivary swelling. Afterward, despite a thorough medical history assessment regarding, in particular the nutritional aspect, the patient continued to deny previous eating disorders nor was there any other helpful information reported by the parents in this regard. Even in the context of normal body weight and no previously known eating disorder, the massive gastric distension following a “reported” single eating binge associated with subsequent delayed gastric emptying, raised the high probability of a severe eating disorder, probably bulimia, at the first clinical and radiological presentation. 5), and an endoscopic study showed no pathological signs in the esophageal and gastric mucosa. Subsequently, after 3 days, he underwent radiography with contrast medium that showed delayed gastric emptying (Fig. A nasogastric tube was placed, and a large amount of gastric contents consisting of partially digested particulate material were evacuated during 3 days (10 l) with partial relief of symptoms. Computed tomography of abdomen and pelvis showed massive gastric distension with a considerable mass effect on adjacent organs by fluid and food resulting in gastric obstruction without perforation (Figs.
#Gastric bubble in diabetic coma x ray free
An abdominal plain film showed a large gastric bubble and a paucity of small bowel gas without evidence of free abdominal air (Fig. Laboratory examinations showed a mild leukocytosis, amylase: 90 U/L, and in the normal range: electrolytes, acid–base, and iron profile, and the hemoglobin value. Temperature was 37 ☌, heart rate: 95 beats per minute, blood pressure 105/75 mmHg, respiratory rate 32 breaths per minute, and body mass index was 22. The remainder of the physical examination was unremarkable. There was no rebound, and no masses were palpable. Physical examination revealed a markedly distended abdomen, and epigastric tenderness with absent bowel sounds. He reported that he was in his usual state of health until the heavy food intake. He had been unable to induce vomiting to reach relief at home. He reported a binge eating several hours before the onset of symptoms. A 23-year-old man with no past medical history presented to the emergency department(ED) with severe, diffuse abdominal pain, and nausea.
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