Mili Takwa, Ahmed Yosra Ben, Chibani Intissar, Boukesra Tarek, Nouira Faouzi, Charieg Awatef, Jlidi Said
Service de Chirurgie Pédiatrique « B », Hôpital d´Enfants de Tunis, Faculté de Médecine de Tunis, Université Tunis El Manar, Tunis, Tunisie.
Pan Afr Med J. 2022 Jul 27;42:238. doi: 10.11604/pamj.2022.42.238.34517. eCollection 2022.
Gastric volvulus is a rare mode of revelation of congenital diaphragmatic hernia. This is an uncommon condition that may be difficult to diagnose in the paediatric population. We here report the case of a three-month-old infant presenting with a rapid worsening of acute dyspnoea. Chest X-ray showed image clarity and ascending gastric air sac. Thoraco-abdominal CT scan showed gastric volvulus complicating left congenital diaphragmatic hernia. Surgical treatment consisted of gastric devolvulation followed by complete reduction of the herniated viscera and closure of the diaphragmatic defect. Patient´s outcome was favourable. Congenital diaphragmatic hernia complicated by gastric volvulus should be considered as a diagnostic and therapeutic emergency due to the risk of life-threatening gastric necrosis.
胃扭转是先天性膈疝的一种罕见表现形式。这是一种不常见的病症,在儿科人群中可能难以诊断。我们在此报告一例三个月大婴儿,表现为急性呼吸困难迅速加重。胸部X光显示影像清晰且胃气囊上升。胸腹CT扫描显示胃扭转并发左侧先天性膈疝。手术治疗包括胃复位,随后完全还纳疝出的内脏并闭合膈肌缺损。患者预后良好。由于存在危及生命的胃坏死风险,先天性膈疝合并胃扭转应被视为诊断和治疗上的紧急情况。