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婴儿未诊断出的先天性膈疝并发嵌顿性胃扭转和脾疝的病例报告

Case Report of Incarcerated Gastric Volvulus and Splenic Herniation in Undiagnosed Congenital Diaphragmatic Hernia in an Infant.

作者信息

Gelman Kate R, Kalaskey Torren A, Seifarth Federico G

机构信息

West Virginia University School of Medicine, Morgantown, WV.

WVU Medicine Children's Hospital, Division of Pediatric Surgery, Morgantown, WV.

出版信息

J Educ Teach Emerg Med. 2025 Jul 31;10(3):V16-V21. doi: 10.21980/J8VD27. eCollection 2025 Jul.

DOI:10.21980/J8VD27
PMID:40766938
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12320996/
Abstract

UNLABELLED

Congenital diaphragmatic hernia is usually diagnosed prenatally and surgically repaired within the first few days of life. It is very rarely associated with acute gastric volvulus, an uncommon surgical emergency in children. A male infant with atypical presentation of acute gastric volvulus was diagnosed and treated by a swift-acting team across two medical centers. The patient presented with generalized abdominal distention and non-productive retching. Upper gastrointestinal series diagnosed acute gastric volvulus. During laparoscopic intervention, the volvulized stomach and the spleen were identified within an undiagnosed congenital diaphragmatic hernia. Corrective surgery was performed, and the patient tolerated a regular diet within days and continues to do well. Given the emergent nature of acute gastric volvulus in children, a high index of suspicion is warranted to quickly initiate potentially life-saving diagnostics and treatment.

TOPICS

Acute gastric volvulus, diaphragmatic hernia, pediatric.

摘要

未标注

先天性膈疝通常在产前被诊断出来，并在出生后的头几天内进行手术修复。它很少与急性胃扭转相关，急性胃扭转是儿童中一种罕见的外科急症。一名表现不典型的急性胃扭转男婴由两个医疗中心的快速反应团队进行了诊断和治疗。该患者表现为全腹膨隆和干呕。上消化道造影诊断为急性胃扭转。在腹腔镜干预过程中，在一个未被诊断出的先天性膈疝内发现了扭转的胃和脾脏。进行了矫正手术，患者在数天内就能够耐受正常饮食，并且恢复良好。鉴于儿童急性胃扭转的紧急性质，需要高度怀疑，以便迅速启动可能挽救生命的诊断和治疗。

主题

急性胃扭转、膈疝、儿科

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d3/12320996/565b276cc6a8/jetem-10-3-v16f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d3/12320996/c3a6240b3aca/jetem-10-3-v16f1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d3/12320996/bccde8c0527a/jetem-10-3-v16f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d3/12320996/565b276cc6a8/jetem-10-3-v16f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d3/12320996/c3a6240b3aca/jetem-10-3-v16f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d3/12320996/67d4b715e3fa/jetem-10-3-v16f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d3/12320996/9f81a3d077b6/jetem-10-3-v16f3.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1d3/12320996/3a82e1352872/jetem-10-3-v16f5.jpg
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本文引用的文献

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Retching Without Vomiting With Acute Abdominal Distension: A Clinical Cue.伴有急性腹胀的干呕但无呕吐：一种临床提示
JPGN Rep. 2023 Sep 25;4(4):e363. doi: 10.1097/PG9.0000000000000363. eCollection 2023 Nov.
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Congenital Diaphragmatic Hernia with Gastric Volvulus and Splenic Herniation: An Unusual Delayed Presentation in a Six-Month Child.先天性膈疝合并胃扭转及脾疝：六个月大婴儿的罕见延迟表现
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儿童胃旋转不良的管理和结局：系统评价。
World J Pediatr. 2019 Jun;15(3):226-234. doi: 10.1007/s12519-019-00244-4. Epub 2019 Mar 21.
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AJR Am J Roentgenol. 2019 Jan;212(1):103-108. doi: 10.2214/AJR.18.20033. Epub 2018 Nov 7.
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