Pastén González A, González Figueroa B, Riquelme Mendoza R, González Jeria P
Hospital Guillermo Grant Benavente. Facultad de Medicina, Universidad de Concepción. Chile.
Cir Pediatr. 2018 Aug 3;31(3):153-157.
Gastric volvulus is a rare cause of acute abdomen in childhood, and it is usually a casual finding. We present the case of a girl with mesenteroaxial gastric volvulus, which was initially treated by endoscopic approach.
8 year-old patient, diagnosed of Down syndrome, who presented sudden and diffuse colic pain, associated with vomiting, sialorrhea and progressive compromise. She entered in bad general condition. At the physical examination it was highlighted a large abdominal mass. In the imaging study, a mesenteroaxial gastric volvulus and wandering spleen were confirmed. It was decided to perform an endoscopic gastric devolvulation under general anesthesia. Subsequently, gastropexy and splenopexy were performed by laparotomic approach. Evolution was uneventful, being discharged at the tenth postoperative day.
Endoscopic gastric devolvulation is an effective procedure in patients with gastric volvulus, especially in cases of great compromise of the general state, in which a prolonged surgery could suppose a greater risk.
胃扭转是儿童急腹症的罕见病因，通常为偶然发现。我们报告一例患有系膜轴型胃扭转的女孩病例，该病例最初采用内镜治疗。
一名8岁唐氏综合征患儿，突发弥漫性绞痛，伴有呕吐、流涎及病情进行性加重。患儿入院时一般状况较差。体格检查发现腹部有一巨大肿块。影像学检查确诊为系膜轴型胃扭转及游走脾。决定在全身麻醉下进行内镜下胃复位术。随后通过开腹手术进行胃固定术和脾固定术。术后恢复顺利，术后第10天出院。
内镜下胃复位术对于胃扭转患者是一种有效的手术方法，尤其适用于一般状况严重受损的病例，此类病例中长时间手术可能带来更大风险。
