Massive gastric dilatation in bulimic patient

Background: A 19-year-old patient presented to the emergency department with abdominal pain, inability to vomit and pain and parasthesia in her left leg. Her abdominal complaints began the evening before after drinking a large amount of milk and water. At that time she had bowel distention with inability to vomit and her symptoms intensified. The patient was a known bulimic with a tendency to ingest large amounts of food and vomit. CT scan of the abdomen was performed on admission, and repeated after gastric decompression after insertion of a nasogastric tube which drained 8 litres of fluid. The following day, the CT scan was repeated.