Lourenço Sara, Pereira Ana Marta, Guimarães Marta, Nora Mário
General Surgery, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, PRT.
Cureus. 2020 Oct 24;12(10):e11123. doi: 10.7759/cureus.11123.
Gastric volvulus is a rare but potentially life-threatening condition, with difficult diagnosis. We present a case report of a demented woman aged 65 years that attended the emergency department with epigastric pain and vomiting for the past 10 days. The chest plain revealed a retrocardiac air-filled mass and the abdomino-pelvic computed tomography confirmed the diagnosis of gastric volvulus. The patient was admitted. A nasogastric tube was introduced, antibiotics and parenteric nutrition were started and the patient didn't eat anything. The patient was operated at fifth day of admission by laparoscopy. There weren't signs of gastric necrosis, so the stomach was mobilized for its natural position on abdominal cavity, the hiatal defect was closed and a Nissen fundoplicature was performed. The post operative period was uneventful and the patient was discharged on the third post-operative day, without any complication. This case illustrates a sub acute presentation form of gastric volvulus and a differed minimally invasive approach attending at the patient's clinical stability.
胃扭转是一种罕见但可能危及生命的疾病，诊断困难。我们报告一例65岁痴呆女性病例，该患者因上腹部疼痛和呕吐10天前来急诊科就诊。胸部平片显示心后区有一个充满气体的肿块，腹盆腔计算机断层扫描确诊为胃扭转。患者入院。插入鼻胃管，开始使用抗生素和肠外营养，患者未进食任何东西。患者在入院第5天接受了腹腔镜手术。没有胃坏死的迹象，因此将胃游离至腹腔内的自然位置，关闭裂孔缺损并进行了nissen胃底折叠术。术后恢复顺利，患者在术后第3天出院，无任何并发症。该病例说明了胃扭转的亚急性表现形式以及在患者临床稳定时采用的微创方法。
