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探索罕见病例并接受新转变:小儿嗜酸性胃炎继发胃出口梗阻的腹腔镜胃空肠吻合术

Navigating Through the Rare and Accepting the New Shift: Laparoscopic Gastro-Jejunostomy for Gastric Outlet Obstruction Secondary to Eosinophilic Gastritis in a Pediatric Patient.

作者信息

Akre Ajinkya, Thorat Santosh, Mhase Akshay C, Shah Preet V

机构信息

General Surgery, Pimpri Chinchwad Municipal Corporation's Postgraduate Institute Yashwantrao Chavan Memorial Hospital, Pune, IND.

Surgical Gastroenterology, Pimpri Chinchwad Municipal Corporation's Postgraduate Institute Yashwantrao Chavan Memorial Hospital, Pune, IND.

出版信息

Cureus. 2024 Jul 27;16(7):e65540. doi: 10.7759/cureus.65540. eCollection 2024 Jul.

Abstract

Eosinophilic gastritis, a rare variant of gastritis, presents with inflammation of the stomach lining due to eosinophil infiltration. This case report describes a complex presentation of eosinophilic gastritis in a 12-year-old boy, highlighting the challenges encountered in management. A 12-year-old male presented with symptoms consistent with gastritis, including abdominal pain, nausea, and vomiting. Despite extensive medical workup to identify potential etiologies (parasitic infections, autoimmune conditions), the diagnosis of eosinophilic gastritis was established. Unfortunately, the patient exhibited persistent symptoms despite aggressive medical management. The case was further complicated by pyloric stenosis, a narrowing of the stomach outlet. Laparoscopic intervention, a minimally invasive surgical approach, was initially attempted but deemed challenging due to the patient's specific condition. The presence of metabolic abnormalities added further complexity. Alternative approaches, such as endoscopic dilatation, were considered but ultimately deemed unsuitable due to the severity of the stenosis and the desire for a minimally invasive solution compared to laparotomy. This case exemplifies the challenges associated with managing rare gastrointestinal conditions like eosinophilic gastritis, particularly in pediatric patients. The report emphasizes the importance of a multidisciplinary approach, involving collaboration between gastroenterologists, surgeons, and potentially other specialists depending on the specific complications, to achieve optimal outcomes. This case highlights the complexities in managing this patient, especially when accompanied by complications like pyloric stenosis. It underscores the crucial role of a multidisciplinary team in navigating challenging presentations and exploring minimally invasive surgical options when feasible.

摘要

嗜酸性胃炎是胃炎的一种罕见变体,由于嗜酸性粒细胞浸润导致胃黏膜炎症。本病例报告描述了一名12岁男孩嗜酸性胃炎的复杂表现,突出了管理中遇到的挑战。一名12岁男性出现与胃炎相符的症状,包括腹痛、恶心和呕吐。尽管进行了广泛的医学检查以确定潜在病因(寄生虫感染、自身免疫性疾病),但仍确诊为嗜酸性胃炎。不幸的是,尽管进行了积极的药物治疗,患者仍有持续症状。病例因幽门狭窄(胃出口变窄)而进一步复杂化。最初尝试了腹腔镜干预(一种微创手术方法),但由于患者的特殊情况而被认为具有挑战性。代谢异常的存在增加了进一步的复杂性。考虑了其他方法,如内镜扩张,但由于狭窄的严重程度以及与剖腹手术相比对微创解决方案的需求,最终认为不合适。该病例体现了管理嗜酸性胃炎等罕见胃肠道疾病相关的挑战,尤其是在儿科患者中。报告强调了多学科方法的重要性,包括胃肠病学家、外科医生以及可能根据具体并发症涉及的其他专家之间的合作,以实现最佳结果。该病例突出了管理该患者的复杂性,尤其是伴有幽门狭窄等并发症时。它强调了多学科团队在应对具有挑战性的表现以及在可行时探索微创外科手术选择方面的关键作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1904/11349146/4bf6cb509dd2/cureus-0016-00000065540-i01.jpg

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