Basaran Umit N, Inan Mustafa, Aksu Burhan, Ceylan Turan
Department of Paediatric Surgery, Medical Faculty, Trakya University, 22030 Edirne, Turkey.
J Paediatr Child Health. 2007 Oct;43(10):710-2. doi: 10.1111/j.1440-1754.2007.01190.x.
Aerophagia, characterized by symptoms related to repetitive swallowing of air, is a functional gastrointestinal disorder. In some cases, severe aerophagia causes massive bowel distention and leads to volvulus, ileus, and even intestinal necrosis and perforation. A 10-year-old intellectually disabled boy was referred to our unit due to severe abdominal distention, bilious vomiting, no passage of feces and flatus during the previous 3 days. He had experienced episodes of severe abdominal distention and flatulence over the past 2-3 years. In the exploratory laparotomy, two old colonic perforations were found. Splenic flexura resection and diverting colostomy were performed. Rectal biopsy showed ganglionic architecture. During the fifth postoperative month, he was admitted to the emergency unit with severe abdominal distention. During this visit, we observed him swallowing air. For this reason, his primary illness was diagnosed as a pathologic aerophagia. The colostomy was closed 11 months following the first operation. His parents did not accept gastrostomy as a desufflator. For this reason, they were taught nasogastric tube installation for gastric distention. Briefly, if abdominal distention increases during the course of the day and increased flatus is observed during sleep, aerophagia could be the primary pathology. If aerophagia could cause complications, gastrostomy should be applied. If the parents refuse gastrostomy, the parents could perform nasogastric tube drainage.
吞气症以反复吞咽空气相关症状为特征，是一种功能性胃肠疾病。在某些情况下，严重的吞气症会导致大量肠扩张，并引发肠扭转、肠梗阻，甚至肠坏死和穿孔。一名10岁智力残疾男孩因严重腹胀、胆汁性呕吐、在过去3天无排便及排气被转诊至我院。在过去2至3年里，他曾多次出现严重腹胀和肠胃胀气。在剖腹探查术中，发现了两处陈旧性结肠穿孔。进行了脾曲切除术和转流性结肠造口术。直肠活检显示有神经节结构。术后第五个月，他因严重腹胀入住急诊病房。此次就诊期间，我们观察到他在吞咽空气。因此，他的原发性疾病被诊断为病理性吞气症。第一次手术后11个月关闭了结肠造口。他的父母不接受胃造口术作为排气装置。因此教会了他们如何安装鼻胃管以缓解胃扩张。简而言之，如果白天腹胀加重且睡眠期间观察到排气增多，吞气症可能是主要病因。如果吞气症会引发并发症，应实施胃造口术。如果父母拒绝胃造口术，他们可以进行鼻胃管引流。
