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肠扭转刺激心肌:一例报告

Volvulus Irritating the Myocardium: A Case Report.

作者信息

Huycke Elizabeth M, Tom Suzanna S, Wezza Alya, Barr Gavin C

机构信息

Department of Emergency and Hospital Medicine, University of South Florida Morsani College of Medicine/Lehigh Valley Health Network Campus, Allentown, USA.

出版信息

Cureus. 2023 Feb 21;15(2):e35256. doi: 10.7759/cureus.35256. eCollection 2023 Feb.

Abstract

Gastric volvulus is a rare condition that may present with various symptoms and may occur as an acute or chronic condition. Signs and symptoms may include nausea, vomiting, abdominal pain, and chest pain. It is imperative to recognize acute gastric volvulus in a timely fashion, since a delay in diagnosis may result in foregut obstruction and increased risk of strangulation, if not recognized and treated promptly. Additionally, secondary complications that are equally life-threatening, such as cardiac arrhythmias, can occur. For this very reason, it is important to highlight gastric volvulus as a possibility when developing a differential diagnosis in patients complaining of abdominal pain. This case report describes a 73-year-old female with no past cardiac risk factors, who presented to the emergency department (ED) with symptoms of supraventricular tachycardia (SVT), intermittent diarrhea, and nausea per emergency medical services (EMS). Upon EMS arrival at the patient's home, her heart rate was 210 beats per minute (bpm). Despite her condition appearing to result from a cardiac condition, imaging studies found a large hiatal hernia through which the stomach had displaced. The patient's stomach had distended, forming a volvulus and placing pressure on thoracic organs. This case highlights a rare but potentially life-threatening cardiac arrhythmia associated with gastric volvulus.

摘要

胃扭转是一种罕见的病症,可能呈现出各种症状,可表现为急性或慢性病症。体征和症状可能包括恶心、呕吐、腹痛和胸痛。及时识别急性胃扭转至关重要,因为如果不能及时识别和治疗,诊断延误可能导致前肠梗阻并增加绞窄风险。此外,还可能发生同样危及生命的继发性并发症,如心律失常。正因如此,在对腹痛患者进行鉴别诊断时,将胃扭转作为一种可能性加以强调很重要。本病例报告描述了一名73岁女性,既往无心脏危险因素,因出现室上性心动过速(SVT)、间歇性腹泻和恶心症状,由紧急医疗服务(EMS)送往急诊科(ED)。EMS到达患者家中时,她的心率为每分钟210次(bpm)。尽管她的病情看似由心脏疾病引起,但影像学检查发现一个大的食管裂孔疝,胃通过该疝发生了移位。患者的胃扩张,形成了扭转并对胸腔器官施加了压力。本病例突出了一种与胃扭转相关的罕见但可能危及生命的心律失常。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f30/10038688/73199d24bd0d/cureus-0015-00000035256-i01.jpg

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