経過中に縦隔気腫を併発した摂食障害の1例

概要

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This is a report on a patient with eating disorder who developed mediastinal emphysema associated with frequent self-induced vomiting. The patient was a 20-year-old male who was admitted to our hospital with complaints of anorexia, self-induced vomiting and psychomotor restlessness. Medical and psychological evaluations were consistent with the diagnosis of eating disorder not otherwise specified according to the DSM-III-R. Chest radiography on the third day after admission showed both mediastinal emphysema and subcutaneous emphysema of the neck and shoulders. There was no history of trauma and lung diseases. Esophagoscopy was not remarkable. Bronchoscopy, however, showed a scar of the ulcer in the left piriform recess. Recurrent self-induced vomitings could be thought to be a contributing factor to the emphysema in this patient. After 10 days of treatment, during which time the patient was free from self-induced vomiting, chest X-ray films became normal. It is suggested that patients with eating disorder, especially those with frequent vomiting episodes, should be examined with careful attention to the complication of mediastinal emphysema.
日本心身医学会の論文
1990-12-01