Penicillinase-producing Neisseria gonorrhoeae: detection by starch paper technique.

Several mechanisms for the development of gastric dilatation in anorexia nervosa have been suggested.In this girl, in three other reported cases,2-4 and in emaciated prisoners of war, recounted from Markowski by Russell,5 dilatation occurred soon after a sudden increase in normal food intake.Scobie:' reports duodenal dilatation as common in anorectic patients undergoing barium meal examination for causes other than gastric dilatation.He suggests that this is a neurogenic complication of malnourishment.Possibly this functional duodenal obstruction exacerbated by a sudden load on the stomach may produce dilatation.This supposition is supported by the presence of upper gastrointestinal tract dilatation in association with some cases of gastric dilatation.2 4 In our case and in Russell's there was no evidence of electrolyte disturbance as a cause for the dilatation.Russell5 suggested that psychogenic factors were important, but other authors'-4 have not reported them nor could we find any in our patient.Drugs may contribute to this complication, but, although most patients have been treated with phenothiazines, one4 was receiving only diazepam.We have been unable to find other reports of gastric dilatation associated with diazepam.Jennings and Klidjian4 quote an incidence of four cases of undefined "paralytic ileus" occurring in 720 patients treated with phenothiazines, but there is no specific mention of gastric dilatation in reports on phenothiazine side effects.