Clinical History
A 31 years-old female comes at our institution for painful and ballooning abdomen. The anamnesis reveals she has eaten large amounts of sticky rice with soft drink. The clinical examination suspectsgastric dilatation and further imaging is required.
Imaging Findings
The suspicion of acute abdomen leads to realize a plain film which shows an important gastric dilatation (fig. 1). The enhanced abdominal CT-scan of the same day depicts a huge gastric dilatationwith compression of small and large bowel, kidneys, spleen and pancreas. Moreover multiple hyperdense filamentous structures were present in the lower part of the stomach corresponding to rice withimportant increased volume (fig. 2-4)
Discussion
Sticky rice also called glutinous rice is a type of short-grained Asian rice. It is called glutinous in the sense of being glue-like or sticky (1). The gastrointestinal tract is protected by itsmucosa epithelium and mucus layer(2). The explanation for the mechanism of obstruction is that mucin molecules, the major constituent of mucus, are protein densely coated with oligosaccharides, whichafford the stickiness and viscosity. Starch, wich makes up most mass of rice, is polysaccharide. Upon hydratation through cooking, rice becomes sticky and increases its volume in the stomach,probably potentialized by soft drink, leading to mass formation and finally to gastric obstruction (3). The refined rices as sticky rice can cause heartburn and ulcer (2,3). In our case gastroscopyshowed two ulcers of the greater curvature of the stomach and retrieved an important alimentary bezoar which led to resolution of the acute abdomen (fig 5).
Differential Diagnosis List
Acute abdomen secondary to sticky rice.
Final Diagnosis
Acute abdomen secondary to sticky rice.
