Department of Pediatric Surgery, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Miki-cho, Kita-gun, 761-0793, Kagawa, Japan.
BMC Pediatr. 2024 Sep 28;24(1):602. doi: 10.1186/s12887-024-05081-7.
Aerophagia is caused by the swallowing of excessive air and associated with various gastrointestinal symptoms. Aerophagia is diagnosed based on the observation of the occurrence of excessive air swallowing or ingestion; however, it tends to be difficult and often delayed. Early recognition and diagnosis of aerophagia are required to avoid unnecessary diagnostic investigations or serious clinical complications. Given that multichannel intraluminal impedance-pH measurement can discriminate gas, liquid, and mixed swallows, it can be useful for the diagnosis of aerophagia.
A 7-year-old girl presented to us with vomiting, and abdominal radiography showed dilatation of the stomach and intestine with no signs of mechanical obstruction. After successful conservative treatment, her symptoms recurred. Along with frequent visible and audible air swallowing, computed tomography (CT) revealed a severely dilated stomach with organoaxial volvulus. Multichannel intraluminal impedance-pH measurement was performed for further exploration. Patients showed numerous air swallows, particularly in the daytime during the 24-h recording period. She was diagnosed with aerophagia complicated by gastric volvulus. Given that she had a mental disorder and psychological counseling was difficult, laparoscopic anterior gastropexy and gastrostomy were performed to correct the gastric volvulus and decompression of gastric dilation by gastrostomy.
In addition to clinical symptoms, multichannel intraluminal impedance-pH measurement may help more accurately and objectively diagnose aerophagia. Further studies of air swallowing patterns may be useful for understanding the pathophysiological mechanism of aerophagia.
吞气症是由于吞咽过多空气引起的，并与各种胃肠道症状有关。吞气症基于观察到过多空气吞咽或摄入而诊断；然而，它往往难以确定且常常被延迟诊断。需要早期识别和诊断吞气症，以避免不必要的诊断性检查或严重的临床并发症。鉴于多通道腔内阻抗-pH 测量可以区分气体、液体和混合吞咽，因此它可用于诊断吞气症。
一名 7 岁女孩因呕吐就诊，腹部 X 线片显示胃和肠扩张，无机械性梗阻迹象。在成功进行保守治疗后，她的症状再次出现。同时频繁出现可见和可闻的空气吞咽，计算机断层扫描（CT）显示胃严重扩张伴器官轴性扭转。进行多通道腔内阻抗-pH 测量以进一步探索。患者表现出多次空气吞咽，尤其是在 24 小时记录期间的白天。她被诊断为吞气症并发胃扭转。鉴于她患有精神障碍且心理咨询困难，因此进行了腹腔镜前胃固定术和胃造口术，以纠正胃扭转和通过胃造口术对胃扩张进行减压。
除了临床症状外，多通道腔内阻抗-pH 测量可能有助于更准确和客观地诊断吞气症。进一步研究空气吞咽模式可能有助于了解吞气症的病理生理机制。
