Massive gastric perforation in a patient with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes: A case report

Figure 1 Magnetic resonance spectroscopy, cranial computed tomography angiography and cerebral computed tomography perfusion images. A and B: Magnetic resonance spectroscopy showed patchy abnormal signal lesions in the left temporo-occipital lobe, and an elevated lactate peak was observed in the left temporal lobe; C and D: Cranial computed tomography angiography and cerebral computed tomography perfusion imaging showed no significant abnormalities.

Figure 2 Whole abdominal computed tomography scan findings and postoperative histological examination. A and B: Perforation of a hollow organ, diffuse thickening of the gastric wall; C: Loss of the superficial mucosal layer in the gastric wall tissue, accompanied by suppurative inflammation.

Figure 3 Intraoperative view. A: A 10 cm laceration extending from the gastric body to the anterior wall of the gastric fundus presented; B: Resected black gangrene surrounding the gastric rupture; C: The gastric rupture was repaired.