Agarwal Anusha, Turshudzhyan Alla, Khamechand Alexander, Schuster Michael, Tadros Micheal
Internal Medicine, Albany Medical College, Albany, USA.
Internal Medicine, University of Connecticut Health, Farmington, USA.
Cureus. 2022 Mar 24;14(3):e23436. doi: 10.7759/cureus.23436. eCollection 2022 Mar.
Systemic scleroderma (SSc) is a chronic autoimmune disorder that can affect various organ systems. About 90% of patients with SSc have gastrointestinal (GI) manifestations, with esophageal dysmotility being the most frequently reported. While esophageal involvement is the most common, other segments of the upper GI tract can be affected as well, such as the stomach or small bowel. Some of the examples of gastric involvement include gastric antral vascular ectasia (GAVE) and gastroparesis. Small bowel involvement can present with reduced contractility, pseudo-obstruction, small intestinal bacterial overgrowth (SIBO), and atrophy. Although many of these manifestations bear little clinical urgency, acute gastric dilation or pseudo-obstruction constitute a medical emergency and require prompt intervention. We are presenting a case of acute gastric dilation with gastric volvulus in the setting of SSc, which is not well reported in the medical literature. We hope to increase providers' awareness of this rare manifestation of SSc to facilitate prompt diagnosis and intervention. Furthermore, we hope to prompt more research to be done to better understand its pathophysiology and determine whether this manifestation of SSc is preventable.
系统性硬化症（SSc）是一种可影响多个器官系统的慢性自身免疫性疾病。约90%的SSc患者有胃肠道（GI）表现，其中食管动力障碍最为常见。虽然食管受累最为常见，但上消化道的其他部分也可能受到影响，如胃或小肠。胃受累的一些例子包括胃窦血管扩张症（GAVE）和胃轻瘫。小肠受累可表现为收缩力降低、假性肠梗阻、小肠细菌过度生长（SIBO）和萎缩。虽然这些表现大多没有临床紧迫性，但急性胃扩张或假性肠梗阻属于医疗急症，需要及时干预。我们报告一例SSc患者发生急性胃扩张并伴有胃扭转的病例，这在医学文献中报道较少。我们希望提高医疗人员对SSc这种罕见表现的认识，以便及时诊断和干预。此外，我们希望促使开展更多研究，以更好地了解其病理生理学，并确定SSc的这种表现是否可以预防。
