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食管裂孔疝伴急性胃扭转

Acute Gastric Volvulus on Hiatal Hernia.

作者信息

Kaoukabi Abdessamad El, Menfaa Mohamed, Hasbi Samir, Sakit Fouad, Choho Abdelkrim

机构信息

General Surgery, Moulay Ismail Military Hospital, Morocco.

出版信息

Case Rep Surg. 2020 Dec 9;2020:4141729. doi: 10.1155/2020/4141729. eCollection 2020.

Abstract

The gastric volvulus is defined as an abnormal rotation of all or part of the stomach around one of its axes, creating the conditions of an upper abdominal obstruction with gastric dilation and risk of strangulation. It is a rare entity that requires a surgical treatment, and its diagnosis is often delayed due to frequently aspecific symptoms. We will describe the observation of a 62 year old patient who presented to the emergency department for acute epigastric pain with dyspnea. The thoracoabdominal CT has demonstrated a stasis stomach on pyloric obstacle evoking a gastric torsion. An upper gastrointestinal endoscopy (EGD) and an upper gastrointestinal contrast made it possible to diagnose an acute gastric volvulus on hiatal hernia. A midline laparotomy was performed with detorsion of the stomach and repair of the hiatal hernia. The patient recovered gradually and was discharged on the sixth postoperative day. Three months after the operation, the patient remained asymptomatic.

摘要

胃扭转被定义为胃的全部或部分围绕其某一轴的异常旋转,从而造成上腹部梗阻、胃扩张以及绞窄风险的情况。它是一种罕见病症,需要手术治疗,且由于其症状常常缺乏特异性,其诊断往往会被延误。我们将描述一位62岁患者的病例,该患者因急性上腹部疼痛伴呼吸困难前往急诊科就诊。胸腹CT显示胃在幽门梗阻处淤滞,提示胃扭转。上消化道内镜检查(EGD)和上消化道造影使得诊断出食管裂孔疝伴急性胃扭转成为可能。进行了中线剖腹手术,对胃进行了扭转复位并修复了食管裂孔疝。患者逐渐康复,并于术后第六天出院。术后三个月,患者仍无症状。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8740/7746469/e49b602dd8f9/CRIS2020-4141729.001.jpg

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