Sun Haijiao, Gao Chang, Wei Xuhui
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
School of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Ann Palliat Med. 2020 Nov;9(6):4389-4393. doi: 10.21037/apm-20-467. Epub 2020 Jun 15.
Gastrolithiasis is one of the uncommon clinical diseases with low incidence and its clinical manifestations are not typical. It is easy to be ignored when combined with other medical diseases. In this paper we present a case of gastrolithiasis just after percutaneous transluminal coronary intervention (PCI), the patient suffered from unexplained persistent abdominal distention and pain with gastric retention, nausea and vomiting. The patient's symptoms were similar to dyspepsia in the first 4 days, so gastrolithiasis wasn't considered, and it became worse with an incomplete intestinal obstruction on the 5th day (see the timeline for details). After a series of examinations, the patient was diagnosed as gastrolithiasis, then after endoscopic removal while taking dual antiplatelet therapy (DAPT), her condition rapidly improved and discharged after a week without any adverse events. Through following-up, the patient is very careful of diet and her digestive system symptoms seldom appear so far. So gastroscopy may be safe in the perioperative period of PCI with no history of upper gastrointestinal bleeding (UGIB). We suggest that the possibility of gastrolithiasis should be considered to avoid adverse consequences when patients have persistent abdominal distention and abdominal pain with gastric retention, which is difficult to determine the causes.
胃石症是一种临床少见、发病率低且临床表现不典型的疾病。当它与其他内科疾病合并存在时，很容易被忽视。本文报道1例经皮冠状动脉腔内血管成形术（PCI）术后并发胃石症的病例，患者术后出现不明原因的持续性腹胀、腹痛伴胃潴留、恶心、呕吐。患者最初4天的症状类似消化不良，因此未考虑胃石症，第5天出现不完全性肠梗阻且病情加重（详见时间线）。经过一系列检查，患者被诊断为胃石症，在内镜下取出胃石的同时给予双联抗血小板治疗（DAPT），患者病情迅速改善，1周后出院，无任何不良事件发生。通过随访发现，患者对饮食非常注意，至今消化系统症状很少出现。因此，对于无消化道出血病史的PCI围手术期患者，胃镜检查可能是安全的。我们建议，当患者出现难以明确病因的持续性腹胀、腹痛伴胃潴留时，应考虑胃石症的可能，以避免不良后果。
