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腹腔镜治疗胃憩室:病例报告及文献综述

Laparoscopic management of a gastric diverticulum: Case report and literature review.

作者信息

Sleiman Youssef, Aby Hadeer Ribal, Farhat Hadi, Moghnieh Razan, Jurdi Nawaf, Abs Leila, Alloush Mustafa

机构信息

Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon.

Department of General and Visceral Surgery, Nini Hospital, Tripoli, Lebanon.

出版信息

Medicine (Baltimore). 2025 Aug 8;104(32):e43858. doi: 10.1097/MD.0000000000043858.

Abstract

RATIONALE

Gastric diverticulum (GD) is a rare condition characterized by an abnormal bulging pouch in the stomach wall, most commonly located in the fundus. Although GD is typically asymptomatic, it can lead to various nonspecific upper gastrointestinal symptoms, posing a challenge for diagnosis and management.

PATIENT CONCERNS

A 28-year-old female patient presented with morning emesis, which prompted an investigation and the eventual diagnosis of a symptomatic GD. The patient's condition was unusual due to her young age and the presence of symptoms typically not associated with GD.

DIAGNOSES

The diagnosis of GD was confirmed after a series of diagnostic tests that included an abdominal ultrasound, abdominal magnetic resonance imaging and barium swallow. The condition is typically rare in younger individuals and can be easily overlooked due to the nonspecific nature of its symptoms.

INTERVENTIONS

An esophagogastroduodenoscopy was ordered to exclude other pathology and showed a gastric fundal diverticulum with preserved architecture and no signs of inflammation. The patient was successfully treated using a laparoscopic approach, which is becoming the treatment of choice for large or complicated gastric diverticula.

OUTCOMES

The laparoscopic surgery resulted in the resolution of the patient's symptoms, with no reported complications post-surgery. The patient had a favorable recovery and was discharged with no ongoing gastrointestinal issues.

LESSONS

This case emphasizes the importance of considering GD in differential diagnoses for patients presenting with vague upper gastrointestinal symptoms, even in younger individuals. It also highlights the effectiveness of laparoscopic surgery as a minimally invasive and successful treatment option for GD.

摘要

理论依据

胃憩室(GD)是一种罕见病症,其特征为胃壁出现异常膨出的囊袋,最常见于胃底。尽管GD通常无症状,但可导致各种非特异性上消化道症状,给诊断和治疗带来挑战。

患者情况

一名28岁女性患者出现晨起呕吐,促使进行检查并最终诊断为有症状的GD。该患者的情况较为特殊,因其年龄较轻且存在通常与GD无关的症状。

诊断

经过一系列诊断测试,包括腹部超声、腹部磁共振成像和吞钡检查,确诊为GD。这种病症在年轻人中通常很少见,由于其症状的非特异性,很容易被忽视。

干预措施

安排了食管胃十二指肠镜检查以排除其他病变,结果显示胃底憩室,结构保存完好,无炎症迹象。患者通过腹腔镜手术成功治疗,腹腔镜手术正成为大型或复杂胃憩室的首选治疗方法。

结果

腹腔镜手术使患者症状得以缓解,术后未报告有并发症。患者恢复良好,出院时无持续的胃肠道问题。

经验教训

该病例强调了对于出现模糊上消化道症状的患者,即使是年轻人,在鉴别诊断中考虑GD的重要性。它还突出了腹腔镜手术作为GD的一种微创且成功的治疗选择的有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5716/12338180/42250ff2e54f/medi-104-e43858-g001.jpg

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