Acute Gastric Dilatation and Duodenal Ileus in Anorexia Nervosa

Acute gastric dilatation developed in two patients during treatment for anorexia nervosa. One recovered after diagnostic laparotomy and the other, who also had a bezoar, responded to conservative therapy. It is recommended that anorexia nervosa patients who are to be submitted to rapid refeeding should have a barium meal X-ray examination, and that they be supervised closely for evidence of gastric retention and incipient dilatation. Conversely, the chance finding of duodenal ileus on barium meal X-ray examination demands a careful assessment of the psychiatric state of the patient. Unrecognized acute dilatation of the stomach may be an important cause of death in patients with anorexia nervosa.