Severe necrotizing sialometaplasia progressing to palatonasal fistula in a patient characterized by habitual self-induced vomiting: a case report.
- 1Department of Psychiatry, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan. [email protected].
- 2Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan.
- 3Department of Psychiatry, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan.
Abstract
Background
Self-induced vomiting (SIV) in patients with eating disorders exposes the oral cavity to repeated chemical and mechanical insults, leading to various oral complications. Necrotizing sialometaplasia (NS) is one such complication; however, most cases resolve spontaneously and follow a benign course without requiring surgical intervention.Case presentation
A woman in her twenties with a long history of an eating disorder characterized by habitual SIV developed NS of the hard palate. Unlike the usual benign course, the lesion failed to heal spontaneously and progressed to a palatonasal fistula. Her clinical course was notable for several behavioral and clinical factors that may have contributed to sustained local irritation of the palatal tissues, such as persistent vomiting, smoking, and dental procedures requiring local anesthesia. Multidisciplinary psychiatric and dental management was provided throughout the clinical course. Since spontaneous closure of the fistula could not be expected, surgical repair was ultimately performed.Conclusions
Although NS associated with SIV in patients with eating disorders is usually benign and self-limiting, it can rarely progress to severe and irreversible oral complications such as a palatonasal fistula. Despite the fact that NS is not life-threatening, its severe progression can significantly impair quality of life. Accumulating clinical experience with such hidden complications may improve the quality of psychoeducation and advance the treatment of eating disorders.
Related
- Immune checkpoint inhibitors (ICIs) for second-line retreatment in esophageal cancer progressing after first-line immunotherapy: a single-center retrospective cohort study
- Immediate graftless rehabilitation of the posterior maxilla using digitally-guided palatonasal cortical engagement with long angled implants: A prospective 12-month pilot cohort
- Rapidly Progressing Interstitial Fibrosis and Glomerulonephritis due to Granulomatosis With Polyangiitis Presenting With Calf Pain
- Bi-allelic intermediate ATXN2 repeat expansions are associated with slow progressing, leg-onset familial ALS
- Prenatal Diagnosis and Perinatal Management of Acrania Progressing to Anencephaly
BibTeX
@article{yamauchi2026severe,
title = {{Severe necrotizing sialometaplasia progressing to palatonasal fistula in a patient characterized by habitual self-induced vomiting: a case report.}},
author = {Haruka Yamauchi and Ayaka Matsumoto and Akihiro Dohi and Yuta Inagawa and Shiro Suda},
journal = {Journal of eating disorders},
year = {2026},
month = jul,
doi = {10.1186/s40337-026-01714-7},
url = {https://europepmc.org/article/MED/42894202},
note = {CC BY},
}
RIS
TY - JOUR
TI - Severe necrotizing sialometaplasia progressing to palatonasal fistula in a patient characterized by habitual self-induced vomiting: a case report.
AU - Haruka Yamauchi
AU - Ayaka Matsumoto
AU - Akihiro Dohi
AU - Yuta Inagawa
AU - Shiro Suda
PY - 2026
DA - 2026/07/01
JO - Journal of eating disorders
DO - 10.1186/s40337-026-01714-7
UR - https://europepmc.org/article/MED/42894202
AB - Background Self-induced vomiting (SIV) in patients with eating disorders exposes the oral cavity to repeated chemical and mechanical insults, leading to various oral complications. Necrotizing sialometaplasia (NS) is one such complication; however, most cases resolve spontaneously and follow a benign course without requiring surgical intervention.Case presentation A woman in her twenties with a long history of an eating disorder characterized by habitual SIV developed NS of the hard palate. Unlike the usual benign course, the lesion failed to heal spontaneously and progressed to a palatonasal fistula. Her clinical course was notable for several behavioral and clinical factors that may have contributed to sustained local irritation of the palatal tissues, such as persistent vomiting, smoking, and dental procedures requiring local anesthesia. Multidisciplinary psychiatric and dental management was provided throughout the clinical course. Since spontaneous closure of the fistula could not be expected, surgical repair was ultimately performed.Conclusions Although NS associated with SIV in patients with eating disorders is usually benign and self-limiting, it can rarely progress to severe and irreversible oral complications such as a palatonasal fistula. Despite the fact that NS is not life-threatening, its severe progression can significantly impair quality of life. Accumulating clinical experience with such hidden complications may improve the quality of psychoeducation and advance the treatment of eating disorders.
SN - 2050-2974
ER -