Chen David P, Walayat Saqib, Balouch Imran L, Martin Daniel K, Lynch Teresa J
Department of Internal Medicine, OSF Saint Francis Medical Center, University of Illinois College of Medicine at Peoria, Peoria, IL, USA.
J Community Hosp Intern Med Perspect. 2017 Oct 18;7(5):325-328. doi: 10.1080/20009666.2017.1379853. eCollection 2017.
Acute gastric volvulus is a life threatening condition requiring early diagnosis and aggressive management. Diagnosis of gastric volvulus remains a challenge for clinicians due to variable, non-specific clinical presentation, which requires a high level of suspicion. It should be considered in patients presenting with chest pain and/or epigastric pain, especially in the elderly population. Endoscopic de-rotation could be initially attempted as a therapeutic modality especially in patients who cannot undergo surgery. However, surgery remains the main stay of treatment. Delay in diagnosis can lead to complications like mucosal ischemia, necrosis or perforation, shock, which substantially increase the morbidity and mortality.
急性胃扭转是一种危及生命的疾病，需要早期诊断和积极治疗。由于临床表现多样且不具特异性，胃扭转的诊断对临床医生来说仍然是一项挑战，这需要高度的怀疑。对于出现胸痛和/或上腹部疼痛的患者，尤其是老年人群，应考虑该病。内镜下复位可作为一种初始治疗方式尝试，特别是对于无法接受手术的患者。然而，手术仍然是主要的治疗手段。诊断延迟可导致诸如黏膜缺血、坏死或穿孔、休克等并发症，这会大幅增加发病率和死亡率。
