Domínguez Jiménez José Luis, Puente Gutiérrez Juan Jesús, Marín Moreno Miguel Alonso, Bernal Blanco Enrique, Gallardo Camacho José Ignacio, Uceda Vañó Antonio
Servicio de Aparato Digestivo, Empresa Pública Hospital Alto Guadalquivir, Andújar, Jaén, España.
Gastroenterol Hepatol. 2008 Oct;31(8):494-6. doi: 10.1157/13127091.
A 72-year-old woman presented to the emergency department with recurrent vomiting without abdominal pain. On physical examination, the patient was afebrile and her abdomen was soft and nontender with a giant abdominal-wall hernia. Upper endoscopy showed a deep, 3-cm ulcer at the gastric angulus. Computed tomography (CT) of the abdomen showed gastric dilatation with gas in the wall and a large part of the digestive tract within the hernia sac. CT imaging also revealed gas throughout the portal venous system. The patient declined surgery. Management was conservative and included correction of fluid and electrolyte balance, and nasogastric drainage for gastric decompression with good response.
一名72岁女性因反复呕吐且无腹痛就诊于急诊科。体格检查时，患者体温正常，腹部柔软且无压痛，有巨大腹壁疝。上消化道内镜检查显示胃角处有一个3厘米深的溃疡。腹部计算机断层扫描（CT）显示胃扩张，胃壁有气体，疝囊内有大部分消化道。CT成像还显示门静脉系统内均有气体。患者拒绝手术。治疗采取保守措施，包括纠正液体和电解质平衡，以及进行鼻胃管引流以减轻胃内压力，效果良好。
