Gastric perforation caused by a bulimic attack in an anorexia nervosa patient: report of a case.

We report a rare case of gastric perforation due to a bulimic attack in a 17-year-old girl suffering from anorexia nervosa. She was admitted to our hospital with the chief complaint of abdominal pain following bulimia. Initially, her symptoms were reduced after drainage using a nasogastric tube. Eight hours later, however, she fell into a state of preshock. Abdominal radiography revealed subphrenic free air. We diagnosed the patient as having diffuse peritonitis. At laparotomy, the stomach was dilated and necrotic with perforation. Almost the entire stomach was resected. Postoperatively, the patient recovered uneventfully. We should therefore be aware of this condition when treating patients with anorexia nervosa who complain of abdominal pain.