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胃出口梗阻导致的胃壁积气和并发气腹:一例报告

Gastric pneumatosis and concurrent aeroportia due to gastric outlet obstruction: A case report.

作者信息

Ebrahimian Manoochehr, Ghayebi Negin, Rezaee Seyed Parviz

机构信息

Department of General Surgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran..

School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int J Surg Case Rep. 2021 Dec;89:106584. doi: 10.1016/j.ijscr.2021.106584. Epub 2021 Nov 11.

Abstract

INTRODUCTION AND IMPORTANCE

Gastric pneumatosis with concurrent hepatic portal vein gas is an extremely rare condition in the adult population. It can be idiopathic or associated with well-known etiologies. Gastric outlet obstruction can progressively inflate the stomach and cause pneumatosis. Regarding abdominal signs and the presence of acute abdomen, management varies from just conservative to emergent surgical interventions.

CASE PRESENTATION

We introduce an adult patient who presented to our hospital with weakness and dyspnea. After initial measures, unexpectedly we found intraabdominal free gas, concurrent gastric pneumatosis, and aeroportia. Due to the absence of positive abdominal signs, the patient was treated successfully without any surgical or endoscopic interventions.

DISCUSSION

Gastric outlet obstruction is a well-known cause of gastric pneumatosis. Progressive dilation of the stomach due to pyloric stenosis is well-described both in infants and adult populations.

CONCLUSION

In stable patients, gastric drainage and correction of electrolyte disturbance are the only required treatment. However endoscopic and surgical interventions should be considered in unstable patients or those developing acute abdomen.

摘要

引言与重要性

成人并发肝门静脉积气的胃壁积气是一种极为罕见的病症。它可能是特发性的,也可能与已知病因相关。胃出口梗阻可使胃部逐渐膨胀并导致胃壁积气。关于腹部体征和急腹症的存在,治疗方法从单纯保守治疗到紧急手术干预不等。

病例介绍

我们介绍一位成年患者,他因虚弱和呼吸困难前来我院就诊。在采取初步措施后,我们意外发现腹腔内游离气体、并发胃壁积气和气腹。由于没有阳性腹部体征,该患者未经任何手术或内镜干预即成功治愈。

讨论

胃出口梗阻是胃壁积气的一个已知病因。幽门狭窄导致胃部逐渐扩张在婴儿和成人中均有详细描述。

结论

对于病情稳定的患者,仅需进行胃引流和纠正电解质紊乱。然而,对于病情不稳定的患者或出现急腹症的患者,应考虑进行内镜和手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff8c/8599093/3a5ca8445435/gr1.jpg

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