ACUTE GASTRIC DILATATION
It is an enormous acute dilatation of stomach with atonic gastric wall without peristalsis. Stomach distends enormously occupying most of the abdomen and pelvis causing sequestration of lots of fluid resulting in hypovolaemia.
Acute gastric dilatation is the radiological finding of a massively enlarged stomach as seen on plain film X-ray or a computerized tomography scan of the abdomen.
CAUSES
- After major surgery (abdomen, neurosurgery).
- Trauma
- burns
- Retroperitoneal haematoma.
- Electrolyte imbalance.
- Other causes: Anorexia nervosa, bulimia, polyphagia, drug abuse, diabetes, anaesthesia, debilitating diseases, spinal cord diseases, muscle dystrophy.
CLINICAL FEATURES
- Features of hypovolaemia and shock.
- Vomiting
- Hiccough
- Vomits large quantity of brownish black fluid like “the storm water of a peat-laden stream.” Vomitus when placed in a test tube and held in a strong light, myriads of small particles may be suspended in the fluid
- Dilated stomach confirmed by ausculto percussion test.
- Positive succussion splash.
- Electrolyte imbalance is seen.
INVESTIGATIONS
- Plain X-ray abdomen
- serum electrolytes
- USG abdomen.
TREATMENT
- Conservative treatment is given initially.
- Large amount of intravenous fluids.
- Ryle’s tube aspiration.
- Electrolyte management,
- Condition has got high mortality.
COMPLICATIONS
- Aspiration pneumonia (Mendelson syndrome).
- Severe hypovolaemia and electrolyte imbalance.
- Raised intragastric pressure causes venous congestion, venous infarction, necrosis and perforation.
- Gastric ischaemia and perforation.
HOMOEOPATHIC MANAGEMENT:
- NUX VOMICA
- PULSATILLA NIGRICANS
- CARBO VEGETABILIS
- ANACARDIUM ORIENTALE
- ABIES NIGRA
- ARSENICUM ALB
