Canarelli J P, Collet L M, Ricard J, Mac Mahon Y, Bernard F
Chir Pediatr. 1987;28(1):59-60.
Gastric volvulus is a rare cause of respiratory distress and vomiting in neonates. This diagnosis was suspected in a 4 week old baby with acute respiratory distress accompanied with vomiting, from the results of an esophagogastroduodenal radiological examination. At operation a gastric volvulus was confirmed, associated with an anatomical malformation: absence of gastrosplenic omentum predisposing to gastric volvulus with mesenterio-axial rotation. Gastropexy was followed by an uncomplicated postoperative course. A literature review confirmed rarity of this affection and raised the problem of causes of repeated vomiting in the newborn and premature infant. An often incriminated lesion is gastric plicature, a radiological notion, whereas gastric volvulus is accompanied necessarily by an altered uptake of contrast in the stomach. Acute volvulus must be distinguished from other types of volvulus, notably that observed during hiatus hernia. Early diagnosis allows rapid surgical treatment by anterior gastropexy as recommended by most authors.
胃扭转是新生儿呼吸窘迫和呕吐的罕见原因。一名4周大的婴儿出现急性呼吸窘迫并伴有呕吐,根据食管胃十二指肠放射学检查结果怀疑有此诊断。手术时证实为胃扭转,并伴有解剖畸形:胃脾韧带缺如,易发生胃扭转并伴有系膜轴旋转。胃固定术后病程顺利。文献综述证实了这种疾病的罕见性,并提出了新生儿和早产儿反复呕吐的病因问题。一种常被归咎的病变是胃襞,这是一个放射学概念,而胃扭转必然伴有胃内造影剂摄取改变。急性扭转必须与其他类型的扭转相区别,尤其是食管裂孔疝时观察到的扭转。早期诊断可根据大多数作者的建议,通过前位胃固定术进行快速手术治疗。