Janalee Heinemann
Executive Director, PWSA (USA)
I recently
received a call from a physician who told me that one of our mother's
brought our Medical Alert articles with her to the emergency room. He said,
"If she had not brought the articles and insisted I go to your web site,
this child would have died. This information saved her life." His
patient, a slim 15-year-old, had an episode of binge eating. She came in
with vomiting and belly pain. The physician said normally, she would have
treated it like the flu for a couple of days. Due to our alerts, they
pursued this further, and found the girl with PWS had such a bad hernia that
her spleen, stomach, and duodenum were in her chest. She is now recovering
from surgery.
Unfortunately, not all parents carry the articles with them and not all
physicians heed our warnings. In another recent situation, a slim young man
had an episode of binge eating and the ER and hospital did not take his
symptoms serious enough, soon enough. Even though we had one of our
physicians called as a consultant and emphasized the urgent need for
exploratory surgery, there was a fourteen to sixteen-hour delay in surgery
before the local hospital physician believed how life threatening his
condition was.
This young
man had been doing very well prior to this incident and a few hours after
the eating episode, initially only exhibited signs of stomach pain and
vomiting. See below for Dr. Rob Wharton’s article which was initially
printed in The Gathered View
in 1999. What Dr. Wharton described was “acute
idiopathic gastric dilation.” This is where part of the stomach
tissue dies which is similar to a heart attack where part of the heart
tissue dies. It comes on suddenly, is very life threatening and needs
immediate surgery. I have been speaking to several people, including our GI
specialist, Dr. Ann Scheimann, and the pathologist who did this report with
Dr. Wharton (who is now deceased) about the cause. Our conjecture is that
if a person with PWS greatly distends their stomach with food (slimmer
people may be more at risk) and does not get the normal message of full or
pain, they may distend it to the point that it cuts off the blood supply
thus causing necrosis. (The stomach becomes blackened and dead.)
Another risk of binge eating that can create a serious medical emergency is
GI perforation. In addition, when there is severe stomach pain, a physician
should consider an ultrasound due to the possibility of gallstones and
pancreatitis.
The pancreatitis can be differentiated by chemistry analysis of the blood
and a CT of the abdomen.
