Risk factors for gastric rupture:
(1) blunt abdominal trauma
(2) excessive eating and/or excessive drinking
(3) excessive ingestion of sodium bicarbonate (which forms carbon dioxide gas when it comes in contact with gastric acid)
(4) gastric inflation (mouth-to-mouth resuscitation, misdirected oxygen administration)
Clinical findings:
(1) onset of severe abdominal pain
(2) free air within the abdomen
(3) diffuse peritonitis
(4) shock
(5) hole or tear in the gastric wall, with leakage of oral radiocontrast material
(6) subcutaneous emphysema (if due to gastric inflation)
Differential diagnosis:
(1) perforation from peptic ulcer
(2) penetrating trauma
(3) chemical burn
(4) ingested foreign body
