Severe hypernatremia and gastric dilation from chronic eating disorder and intentional salt ingestion

We report the case of a 21-year-old female presenting with severe hypernatremia and a gastric outlet obstruction due to chronic purging behavior with salt water flushes. She presented obtunded following emesis and a witnessed seizure. She was found to have a corrected sodium level of 177  mmol/L. Following initial intubation and resuscitation, her CT imaging showed massive gastric dilation with high-density material in the gastric lumen. After orogastric flushing was unsuccessful and the patient's abdominal distention worsened, she was managed surgically and found to have a salt b ezoar leading to bowel ischemia and perforation.
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research