Martins Diana, Sousa Paula, Pinho Juliana, Ruivo Joana, Araújo Ricardo, Cancela Eugénia, Castanheira António, Ministro Paula, Silva Américo
Gastroenterology Department, Tondela-Viseu Hospital Center, Viseu, Portugal.
Radiology Department, Tondela-Viseu Hospital Center, Viseu, Portugal.
ACG Case Rep J. 2017 Apr 12;4:e59. doi: 10.14309/crj.2017.59. eCollection 2017.
We report a 47-year-old man who underwent endoscopic gastrostomy placement due to feeding refusal and regurgitation. Procedure was unremarkable. Two days later, the patient presented signs of intestinal obstruction. Computed tomography imaging showed a well-positioned gastrostomy tube, small pneumoperitoneum, and small bowel volvulus (SBV) in the upper right abdomen with proximal small bowel dilated loops. Exploratory laparotomy revealed mesenteric torsion, leading to SBV, with no evidence of intestinal malrotation. Volvulus was successfully untwisted via surgery. This case highlights to the possible association between SBV and gastrostomy placement.
我们报告一例47岁男性，因拒绝进食和反流而接受内镜下胃造口术置管。手术过程顺利。两天后，患者出现肠梗阻症状。计算机断层扫描成像显示胃造口管位置良好，少量气腹，右上腹小肠扭转（SBV），近端小肠肠袢扩张。剖腹探查发现肠系膜扭转，导致SBV，无肠旋转不良证据。通过手术成功解除了扭转。该病例突出了SBV与胃造口术置管之间可能存在的关联。
