A Case of Acute Gastric Dilatation Accompanied by Diabetic Neuropathy

Abstract

A 76-year-old man had been treated for diabetes mellitus at our hospital over a 30 year period. At the age of 71 years he developed diabetic retinopathy. Since the age of 73 years, his feet had felt numb, and a diagnosis of diabetic neuropathy was made. At 75 years of age, he complained of upper abdominal fullness, and endoscopic examination revealed superficial gastritis. An Abdominal echogram showed normal images of the liver, gallbladder and pancreas. The patient's HbA1C levels had ranged from 7.0 to 7.5 % since age 72. developeda gait disturbance two days prior to examination. He was admitted because of left partial hemiparalysis, diagnosed as due to cerebral infarction. On admission his abdomen was full. On the 4th day, he developed hypovolemic shock after sudden voming. An Abdominal X-ray showed gastric dilatation. A chest X-ray showed pneumonia and pulmonary edema. A diagnois of hypovolemic shock and aspiration pneumonia as a result of acute gastric dilatation was made. The patient died as a result of multiple organ failure on his 7th hospital day. The acute gastric dilatation may have occurred because of gastric paralysis resulting from diabetic neuropathy. © 1995, THE JAPAN DIABETES SOCIETY. All rights reserved.