Acute Dilatation Of The Stomach

This condition is not well understood, nor is its frequence known,

but not a few instances of shock are due to dilatation of this

organ. The shock to the heart may be a reflex one through the

pneumogastric nerves.

It perhaps not infrequently occurs after abdominal operations and is

more or less serious, the symptoms being persistent vomiting, upper

abdominal distention and collapse. The vomiting is of bloody or

coffee-ground material.

Sometimes the ordinary treatment of the collapse and washing out the

stomach save the patient; at other times the patient with this

series of symptoms dies in spite of all treatment.

It has been shown that acute dilatation of the stomach may occur in

pneumonia, and may be one of the causes of cardiac collapse in


When the condition is diagnosed, the treatment would be that of

shock plus abdominal bandage and washing out the stomach with warm

solutions, if the patient is not too collapsed, or at any rate the

frequent administration of hot water in small quantities.

Sometimes when the stomach is dilated the pylorus becomes

insufficient, and bile regurgitates into the stomach, and is a cause

of the profound nausea and vomiting arid the subsequent collapse. In

these cases

114. Henderson: Am. Jour. Physiol., February and April, 1909. not

infrequently small doses of dilute hydrochloric acid seem to aid the

pylorus to maintain its normal contraction, the regurgitation of

bile does not take place, and the stomach may soon acquire a more

normal muscle tone. Not infrequently when a stomach is in this kind

of trouble and all the foods are rejected, and yet the patient

seriously needs nourishment, a warm, thin cereal, as oatmeal or

gruel or something similar, may be retained. Such patients, as has

been repeatedly stated, need starch as soon as possible, lest an

acidosis develop.

In these vomiting and collapse cases the hypodermic administration

of morphin and atropin will not only stop the vomiting, at least

temporarily, but will also give necessary rest. The dose of morphin

need not be large, and the atropin may prevent nausea from the drug.

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