Leung Edmund, Barnes Ruth, Wong Ling
Department of Surgery, University Hospitals Coventry and Warwickshire, Coventry, UK.
J Med Case Rep. 2008 Oct 2;2:323. doi: 10.1186/1752-1947-2-323.
Gastric outlet obstruction usually presents with non-bilious vomiting, colicky epigastric pain, loss of appetite and occasionally, upper gastrointestinal bleeding. Causes can be classified as benign or malignant, or as extra- or intraluminal. Gastrojejunostomy is a well-recognised surgical procedure performed to bypass gastric outlet obstruction. A bezoar occurs most commonly in patients with impaired gastrointestinal motility or with a history of gastric surgery. It is an intestinal concretion, which fails to pass along the alimentary canal.
A 62-year-old Asian woman with a history of gastrojejunostomy for peptic ulcer disease was admitted to hospital with epigastric pain, vomiting and dehydration. All investigations concluded gastric outlet obstruction secondary to a "stricture" at the site of gastrojejunostomy. Subsequent laparotomy revealed that the cause of the obstruction was a bezoar.
Many bezoars can be removed endoscopically, but some will require operative intervention. Once removed, emphasis must be placed upon prevention of recurrence. Surgeons must learn to recognise and classify bezoars in order to provide the most effective therapy.
胃出口梗阻通常表现为非胆汁性呕吐、上腹部绞痛、食欲不振，偶尔还会出现上消化道出血。病因可分为良性或恶性，也可分为腔外或腔内。胃空肠吻合术是一种公认的用于绕过胃出口梗阻的外科手术。胃石最常见于胃肠动力受损或有胃手术史的患者。它是一种肠道结石，无法通过消化道。
一名62岁的亚洲女性，因消化性溃疡疾病接受过胃空肠吻合术，因上腹部疼痛、呕吐和脱水入院。所有检查均得出结论，胃出口梗阻是由于胃空肠吻合部位的“狭窄”所致。随后的剖腹手术显示，梗阻的原因是胃石。
许多胃石可以通过内镜切除，但有些需要手术干预。一旦切除，必须强调预防复发。外科医生必须学会识别和分类胃石，以便提供最有效的治疗。
