Death due to duodenal obstruction in a patient with an eating disorder: a case report.

OBJECTIVE: A 30-year-old woman with a 2-year history of bulimia nervosa and severe abdominal pain after excessive food consumption visited our emergency room. Her abdomen showed marked generalized distension.

METHOD: Aspiration of the gastric contents was not successful, and despite efforts to resuscitate her, the patient died.

RESULT: An autopsy showed a markedly distended stomach containing approximately 6,500 ml of solid foods. The aortomesenteric distance was <1.0 cm and the aortomesenteric angle was <20 degrees, suggesting superior mesenteric artery (SMA) syndrome may have been a cause of death.

CONCLUSION: However, her condition was also consistent with duodenal obstruction due to a heavy stomach and high intra-abdominal pressure, and her cause of death was diagnosed as intestinal obstruction due to an excessive volume of food.