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

Acute gastric dilatation is a rare but life-threatening condition. The case involves a 15-year-old boy who experienced severe abdominal pain, bloating, and vomiting after consuming a large amount of food at once. Physical examination revealed signs of peritonitis and shock with a heart rate of 154 beats per minute. Laboratory tests showed severe metabolic acidosis (pH 7.265) and elevated lactate levels (11.3 mmol/L). CT imaging confirmed massive gastric dilatation and gas accumulation in the portal vein. The patient underwent surgery within 2 hours of admission, and two areas of necrosis were found in the stomach. After surgery and 5 days of intensive care, the patient recovered and was discharged on postoperative day 14. This case demonstrates that even healthy individuals without eating disorders can develop this condition after consuming large amounts of food at once.