Masabarakiza Jean Bosco, Zhu Lingna, Gorur Yilmaz, Cardos Benoît, Lorenzo-Villalba Noel, Ali Deeba
Service des Urgences, CHU Sart-Tilman, Liège, Belgium.
Service de Radiologie, Clinique André Renard, Herstal, Belgium.
Eur J Case Rep Intern Med. 2021 Oct 6;8(10):002818. doi: 10.12890/2021_002818. eCollection 2021.
Acute gastric volvulus is a rare complication affecting 4% of hiatal hernias. It is described as an abnormal rotation of the stomach around a transverse or longitudinal axis and can be intra-abdominal or intrathoracic. Intrathoracic gastric volvulus can lead to tension gastrothorax, which is defined as the presence of a massive gastric distension in the chest cavity causing a mediastinal shift with haemodynamic instability and a risk of cardiorespiratory arrest. We report a case of intrathoracic gastric volvulus with probable tension gastrothorax. Early diagnosis of gastrothorax with computed tomography and immediate insertion of a nasogastric tube resulted in rapid clinical improvement. Surgical intervention is the treatment of choice.
Tension gastrothorax should be suspected in the presence of abdominal and chest pain, vomiting and haemodynamic instability.Prompt diagnosis and treatment are necessary to reduce morbidity and mortality.
急性胃扭转是一种罕见的并发症，发生率为食管裂孔疝的4%。它被描述为胃围绕横轴或纵轴的异常旋转，可分为腹内型或胸内型。胸内胃扭转可导致张力性胃胸，定义为胸腔内胃大量扩张，导致纵隔移位，伴有血流动力学不稳定和心肺骤停风险。我们报告一例可能为张力性胃胸的胸内胃扭转病例。通过计算机断层扫描早期诊断胃胸并立即插入鼻胃管，使临床症状迅速改善。手术干预是首选治疗方法。
出现腹痛、胸痛、呕吐和血流动力学不稳定时应怀疑张力性胃胸。及时诊断和治疗对于降低发病率和死亡率至关重要。
