Acute Dilatation of the Stomach in a Patient with Anorexia Nervosa

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Abstract
It is generally believed that anorexia nervosa is due to an abnormal attitude of mind which results in an insufficient intake of food. As the term anorexia nervosa implies, many patients experience a loss of appetite, but sometimes this is not so, and vomiting is an alternative or additional device adopted by the patient to ensure a reduction in effective food intake. As a rule the patient induces vomiting by tickling her throat with her fingers, but sooner or later she becomes so proficient at vomiting that mechanical stimulation is no longer necessary. Nevertheless one should not assume that vomiting in anorexia nervosa is always under the control of the patient's will. In the patient described below vomiting became intractable and was found to be due to a physical disorder—acute dilatation of the stomach. Such a complication occurring in a severely undernourished patient is highly dangerous unless recognized early and treated effectively. The opportunity was taken to measure water absorption and gastric motility.