Idiopathic Gastric Fundal Perforation in a Young Male

Gastric perforation is a life-threatening condition encountered in surgical emergency. Common conditions that cause gastric perforation requiring emergency exploration include peptic ulcers, trauma, iatrogenic injuries and corrosive burns. Gastroduodenal region is the most common site of perforation but perforation in fundus of stomach is unusual. Acute Gastric Dilation (AGD) is a rarely encountered condition that leads to vascular compromise of stomach wall causing ischaemia and necrosis. Hereby reporting the case of a 26-year-old male, who presented with complaint of abdominal pain following heavy meal. Erect skiagram of chest was diagnostic of hollow viscous perforation peritonitis and the patient underwent emergency exploratory laparotomy. A perforation was noted over the posterior aspect of fundus of dilated stomach. Gastric fundectomy and feeding jejunostomy was done. The surgeon should be aware of such cases of AGD, with fundal perforation for active and appropriate management.