CASE REPORT article

Front. Med.

Sec. Gastroenterology

Pneumomediastinum by acute gastric dilation after binge-eating: a case report and literature review

  • 1. Peking Union Medical College Hospital, Beijing, China

  • 2. Southmead Hospital, Bristol, United Kingdom

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Abstract

Acute gastric dilation (AGD) is a rare but critical medical condition characterized by a rapid and massive expansion of the stomach. While AGD secondary to binge-eating has been documented in literature, cases involving rapid consumption of carbonated beverages leading to acute gastric distention with subsequent pneumomediastinum are rarely reported. We present a case of a 17-year-old male who developed AGD following competitive ingestion of hamburgers and carbonated beverages, subsequently complicated by subcutaneous and mediastinal emphysema. Despite immediate gastric decompression via a nasogastric tube, the patient developed hemodynamic instability and oliguria. An emergency exploratory laparotomy was performed, during which a total of 3.6 liters of gastric contents were aspirated. The patient recuperated gradually under supportive care. This case highlights the necessity of early gastric decompression in binge-eating patients with significant carbonated beverage consumption who develop abdominal symptoms. The onset of hemodynamic instability or oliguria mandates urgent surgical intervention.

Summary

Keywords

Binge-eating, Emergency Medicine, Gastric dilation, Gastroenterology, Pneumomediastinum

Received

05 October 2025

Accepted

04 February 2026

Copyright

© 2026 Lu, Guo, Zhu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Yi Li

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