Yuen M L, Somers S, McGrath F P
Department of Radiology, Chedoke-McMaster Hospitals, Hamilton, Ont.
Can Assoc Radiol J. 1992 Feb;43(1):40-4.
Gastric ulceration after fundoplication for gastroesophageal reflux is relatively uncommon, occurring in 1% to 3% of cases. During the period 1974 to 1979, approximately 100 modified Belsey fundoplications were performed at McMaster University Medical Centre. In four patients gastric ulceration developed after the surgery. In all cases the ulcers were located in the proximal stomach, an unusual site. Published reports of gastric ulceration after fundoplication were reviewed, special attention being given to the cause. The authors conclude that local ischemia and mechanical trauma are important in the development of ulceration, which can occur as early as one week after fundoplication. The detection of ulcers requires awareness of the condition and special attention to the symptoms. Because the gastric anatomy is altered by the fundal wrap, the area can be visualized more easily by double-contrast barium studies than by endoscopy.
胃食管反流病行胃底折叠术后发生胃溃疡相对少见，发生率为1%至3%。1974年至1979年期间，麦克马斯特大学医学中心约进行了100例改良Belsey胃底折叠术。术后有4例患者发生胃溃疡。所有病例的溃疡均位于胃近端，这是一个不寻常的部位。对已发表的胃底折叠术后胃溃疡的报告进行了综述，特别关注其病因。作者得出结论，局部缺血和机械性创伤在溃疡形成过程中起重要作用，溃疡最早可在胃底折叠术后一周出现。溃疡的检测需要对该情况有所认识并特别关注症状。由于胃底折叠改变了胃的解剖结构，与内镜检查相比，双重对比钡餐检查能更轻松地观察到该区域。
