Bleacher J C, Boline G B, Decter R M, Conter R L
Department of Surgery, Pennsylvania State University, College of Medicine, Milton S. Hershey Medical Center, Hershey 17033.
J Pediatr Surg. 1993 Dec;28(12):1579-81. doi: 10.1016/0022-3468(93)90104-s.
A variety of complications have been described after placement of a Stamm gastrostomy in infants and children, including gastric volvulus, pancreatitis, jaundice, gastroduodenal mucosal intussusception with gastric outlet obstruction, and even aortogastric fistula. However, this is the first report of pyeloduodenal fistula after Stamm gastrostomy in a 4 1/2-month-old boy. The child successfully underwent nonoperative therapy; he was treated by withdrawing the gastrostomy tube (Foley catheter) from the renal pelvis, bowel rest, and total parenteral nutrition. After the case presentation is a brief review of this rare entity, with its clinical presentation and pathophysiological differences between adult and pediatric cases. Various treatment options, both operative and nonoperative, are also described.
婴幼儿和儿童行 Stamm 胃造口术后已被描述出多种并发症,包括胃扭转、胰腺炎、黄疸、伴有胃出口梗阻的胃十二指肠黏膜套叠,甚至主动脉胃瘘。然而,这是首例关于一名 4 个半月大男孩行 Stamm 胃造口术后出现肾盂十二指肠瘘的报告。该患儿成功接受了非手术治疗;通过从肾盂拔出胃造口管(Foley 导管)、肠道休息和全胃肠外营养进行治疗。病例报告之后是对这种罕见病症的简要综述,包括其临床表现以及成人和儿童病例在病理生理方面的差异。还描述了各种手术和非手术治疗方案。