Nishihara Yuichi, Kawaguchi Yoshiki, Urakami Hidejiro, Seki Shiko, Ohishi Takashi, Isobe Yoh, Matsumoto Sumio
Department of Surgery, National Hospital Organization, Tokyo Medical Center, Tokyo, Japan.
Asian J Endosc Surg. 2016 Nov;9(4):318-321. doi: 10.1111/ases.12309. Epub 2016 Jul 26.
We report a case of gastric volvulus with a large Bochdalek hernia successfully treated with emergency endoscopic reduction followed by elective laparoscopic mesh repair. The patient was a 71-year-old woman with no history of trauma. She was referred to our hospital because of nausea and vomiting after eating. Thoracic and abdominal CT showed gastric volvulus and a large Bochdalek hernia. The patient underwent emergency endoscopic reduction and elective laparoscopic surgery. The defect (10 × 12 cm) was reinforced with a Dual Mesh (expanded polytetrafluoroethylene) and fixed to the diaphragm with nonabsorbable sutures. The postoperative course was uneventful, and no complications or recurrence was found at the 2-year follow-up. The endoscopic reduction and elective laparoscopic procedure was performed successfully and resulted in significant clinical improvement in this case.
我们报告一例伴有巨大Bochdalek疝的胃扭转病例，该病例通过急诊内镜复位并随后进行择期腹腔镜补片修补术获得成功治疗。患者为一名71岁女性，无外伤史。她因进食后恶心呕吐被转诊至我院。胸部和腹部CT显示胃扭转和巨大Bochdalek疝。患者接受了急诊内镜复位和择期腹腔镜手术。用双层补片（膨体聚四氟乙烯）加强缺损（10×12厘米），并用不可吸收缝线固定于膈肌。术后病程顺利，在2年随访中未发现并发症或复发。该病例成功实施了内镜复位和择期腹腔镜手术，临床症状得到显著改善。
