Huang-Pacheco Andrew, Thomas Patrick, Zarroug Abdalla, Shah Adil A
Division of Gastroenterology, Department of Pediatrics, University of Nebraska Medical Center and College of Medicine, Omaha, NE, United States.
Division of Pediatric Surgery, Department of Surgery, University of Nebraska Medical Center and College of Medicine, Omaha, NE, United States.
J Surg Case Rep. 2025 Aug 6;2025(8):rjaf584. doi: 10.1093/jscr/rjaf584. eCollection 2025 Aug.
We report the first pediatric use of a laparoscopic-assisted endoscopic overstitch technique for managing an acutely perforated gastric ulcer in a 16-year-old female. The patient presented with symptoms consistent with gastrointestinal perforation, confirmed by radiologic pneumoperitoneum. Diagnostic laparoscopy identified inflammatory adhesions and a gastric ulcer perforation. Concurrent endoscopy precisely located the defect, which was effectively closed using an endoscopic overstitch device mounted on a therapeutic double-channel gastroscope. Closure involved three full-thickness inverted figure-of-eight sutures, verified by an intraoperative leak test and reinforced with an omental patch. Postoperative recovery was rapid and uncomplicated, progressing to a regular diet within 3 days. This innovative hybrid laparoscopic-endoscopic technique demonstrates efficacy, safety, and the benefits of minimally invasive surgery for pediatric gastrointestinal perforations, emphasizing its potential superiority over traditional methods.
我们报告了首例在一名16岁女性中使用腹腔镜辅助内镜套扎技术治疗急性胃溃疡穿孔的儿科病例。患者表现出与胃肠道穿孔相符的症状，经放射学检查证实有气腹。诊断性腹腔镜检查发现炎性粘连和胃溃疡穿孔。同时进行的内镜检查精确地定位了缺损部位，使用安装在治疗性双通道胃镜上的内镜套扎装置有效地封闭了缺损。封闭过程包括三针全层倒“8”字缝合，术中渗漏试验证实缝合效果，并使用网膜补片加强。术后恢复迅速且无并发症，术后3天内即可恢复正常饮食。这种创新的腹腔镜-内镜联合技术证明了其在小儿胃肠道穿孔治疗中的有效性、安全性以及微创手术的优势，强调了其相对于传统方法的潜在优越性。
