WARNING Content of this page and the pictures are graphic. WARNING
I was conflicted about how much of this information to include, especially with the photograph, but I've put up all of it because of the impact it had on me and my feelings about eating disorders. I hope that, rather than be offended by this, you'll read it and see her not as a faraway example in a textbook, but as a real person who died as an example.

click to see her gastric contents measured
click to see the body

This article is from an unknown source.

She was 19 and had anorexia and bulimia for 5 years.
Died at 5'1" (155cm) and 94lbs (43kg) after her stomach ripped after eating 5.6 litres of food.

Case notes:
She was in full rigor mortis - which is present from 12-72 hours. The bruises set the timeframe at around 8+ hours. Her eyes had clouded, which happens at progressively from about 2-4 hours on. If you look really closely at her stomach you can see a greenish tint, which a typical sign of her internal organs decaying - called putrefaction*. I think this process may have been accelerated as her insides were digested since it normally takes a few days to set in.

The bruises called for the autopsy. Because of her position when her stomach exploded it spilled all it's contents into her body cavity. The blood and food settled around her anus and vagina and caused what were looked like "fresh bruises." So to rule out sexual stuff, they had to autopsy.

When they did the autopsy they found that her stomach had been extended from where your ribs meet each other all the way to her pubic bone, right behind that pad of fat above the genitals. And her stomach had a large rip in it.

She also had some other abnormalities going on. Her heart was small and displayed typical characteristics of a starving heart - destroyed muscles and dead immune cells (lipofusin bodies). Her brain had swelled, my guess due to the massive increase in blood flow after her stomach ruptured - it had started to squeeze out her skull before she died. She also had evidence of focal pneumonia in her lungs - not really surprising as starvation hurts the immune response to viruses.

Like a typical binger her stomach was dying before it ripped. What I mean is that every time we binge our stomachs expand, if they expand far enough the vessels supplying them blood are crushed - cutting off the blood supply to that area, killing the tissue. That area is weakened and the next binge of that caliber becomes more dangerous. Purging just adds fuel to the fire by increasing stomach pressure above and beyond the natural level.

But believe it or not the ruptured stomach didn't kill her. A natural reaction did. When the stomach exploded her body responded with a typical immune reaction. It dilated her blood vessels, her blood pressure dropped, she blacked out, and her heart slowed down and stopped.

They also did a tox screen and found nothing. I sent a email to the PI asking whether it could detect certain things like laxs, as they suggested they contributed by dehydrating her, but haven't heard back. Potassium levels are of no use as when you die potassium leaks out of your cells.

Another things to note about this. Back in the 1800s they determined that the stomach should only be able to hold 4liters of stuff (by filling corpses). To surpass this we have to adapt our stomach sizes - resulting in gastric dilation. Ruptures via overfilling the stomach appear along the lesser curvature of the stomach, whereas vomiting induced ruptures normally occur along the greater curvature and fundus (the top of the stomach) - it's unusual that her stomach ripped how it did, right down the front.

Apart from the intellectual value of the report it does illustrate an important point - the endpoint of these diseases is very ugly. There is no glamour or beauty spending your last living moments over a toilet.

*Correction made on 1.20.05 - Previously the article stated that the greenish tint was due to livor mortis. Livor mortis is what you will notice on the bottom of her legs and arms and I am sure if you were to turn her over, on her face. The term livor mortis is the settling of the blood to the lowest point, determined by gravity. When the heart stops pumping blood, it settles; that is the purplish discoloration. Thanks to Victoria for this correction.

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