Rare event
Invariable leads to necrosis with or without perforation
Most commonly a post-operative complication
Post-operative complication (Nissen fundoplication)
Occurs after binge eating episodes, typically in those with an eating disorder
Bulimia nervosa
Also psychogenic polyphagia
Mechanical obstruction
Pyloric stenosis
Stricture/adhesions
SMA syndrome
Gastric volvulus
Other etiologies including Diabetes mellitus, trauma, spinal conditions
Bulimia nervosa
Also psychogenic polyphagia
Pyloric stenosis
Stricture/adhesions
SMA syndrome
Gastric volvulus
Intragastric pressure >20mmHg leads to impaired intramural blood flow and mucosal necrosis
Gastric volumes greater than 4 liters lead to regular mucosal tears
Patients with pathologic eating disorders can have larger gastric volumes at baseline<unk>  massive gastric dilation is an extreme form (intragastric pressure >30)
Acute gastric dilatation
ACS/MI
Undifferentiated upper gastrointestinal bleeding
Boerhaave's
Clogged G-tube
DKA
Gastric volvulus
Intracranial Hemorrhage