Saint Peter's University Hospital/Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
J Investig Med High Impact Case Rep. 2023 Jan-Dec;11:23247096231173400. doi: 10.1177/23247096231173400.
Gastric volvulus is a rare medical condition that necessitates a high suspicion index to diagnose. Acute gastric volvulus will often present with nonspecific but severe symptoms of abdominal pain, nausea, vomiting, and in some instances, evidence of organ ischemia. In this case report, we present an 88-year-old woman who was admitted after a mechanical fall. On the third day of hospitalization, she complained of new-onset epigastric pain, nausea, and vomiting. Imaging demonstrated nonobstructed intrathoracic organo-axial gastric volvulus. Given the patient's significant comorbidities, surgical and endoscopic interventions were deemed high-risk (high risk of anesthesia and gastric perforation, respectively). This report evaluates the role of noninterventional conservative management in high-risk surgical patients with symptomatic acute and acute-on-chronic intrathoracic gastric volvulus. The present case and the current literature review suggest that supportive management may be appropriate to control disease symptoms, although it does not alter the disease's natural history, progression, and recurrence.
胃扭转是一种罕见的医学病症，需要高度怀疑才能确诊。急性胃扭转常表现为非特异性但严重的腹痛、恶心、呕吐，在某些情况下还伴有器官缺血的证据。在本病例报告中，我们介绍了一位 88 岁的女性患者，她因机械性跌倒后入院。住院第 3 天，她诉上腹新发性疼痛、恶心和呕吐。影像学检查显示非梗阻性胸腔内器官轴型胃扭转。鉴于患者有明显的合并症，手术和内镜介入被认为风险较高（分别存在麻醉和胃穿孔的高风险）。本报告评估了非介入性保守治疗在有症状的急性和急性慢性胸腔内胃扭转高危手术患者中的作用。本病例和当前的文献复习表明，支持性治疗可能适合控制疾病症状，尽管它不会改变疾病的自然病程、进展和复发。
