Gastric rupture secondary to bulimia is a rare complication of anorexia nervosa first described in 1968. We present a case of an 18-year-old woman who presented to the Emergency Department with acute gastric rupture leading to both tension pneumoperitoneum and tension pneumothorax. Although case reports of spontaneous pneumoperitoneum and separate reports of spontaneous pneumothorax in anorexic patients have been published, none of them has been associated with gastric rupture.
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