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

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.