Johnson Shepard Peir, Roose Benjamin, Brandt Mary-Margaret, Anderson Harry Linne
Department of Surgery, St Joseph Mercy Ann Arbor, Ann Arbor, Michigan, USA.
BMJ Case Rep. 2017 Jun 22;2017:bcr-2017-220115. doi: 10.1136/bcr-2017-220115.
Strangulated gastric prolapse through a percutaneous endoscopic gastrostomy tract is a rare and potentially life-threatening complication that requires surgical intervention. We describe a case of a 74-year-old woman who was debilitated and ventilator-dependent and who presented with acute gastric prolapse with resultant ischaemic necrosis. The patient underwent an emergent exploratory laparotomy, partial gastrectomy, repair of gastrostomy defect and placement of a gastrojejunostomy feeding tube remote to the previous location. Literature on gastric prolapse in adult patients is sparse, and therefore treatment is not standardised. In this patient with strangulated tissue, the principles of management included the assessment of gastric mucosa viability, resection of ischaemic tissue and closure of the gastrostomy defect.
经皮内镜胃造口通道绞窄性胃脱垂是一种罕见且可能危及生命的并发症，需要手术干预。我们报告一例74岁女性病例，该患者身体虚弱且依赖呼吸机，出现急性胃脱垂并导致缺血性坏死。患者接受了急诊剖腹探查、部分胃切除术、胃造口缺损修复以及在远离先前位置放置空肠造口喂养管。关于成年患者胃脱垂的文献稀少，因此治疗尚无标准化方案。对于该有绞窄组织的患者，治疗原则包括评估胃黏膜活力、切除缺血组织以及关闭胃造口缺损。
