Leitão B, Mota C R, Enes C, Ferreira P, Vieira P, Requeijo D
Department of Pediatric Surgery, Hospital Maria Pia Porto, Portugal.
Eur J Pediatr Surg. 1997 Apr;7(2):106-8. doi: 10.1055/s-2008-1071065.
Acute gastric volvulus in infancy is a rare disorder and a surgical emergency. Prompt clinical suspicion and radiological assessment are essential for this life-threatening condition. We report a 3-month-old female case, admitted for an initial suspicion of an intestinal obstruction. She presented unproductive retching, respiratory distress, epigastric distension and lethargy. It was not possible to introduce a naso-gastric tube. A radiological contrast study showed an occluded cardio-esophageal junction without passage of barium, two gastric fluid levels and a horizontally positioned stomach occupying the inferior portion of the left hemithorax, suggesting a left diaphragmatic hernia. Laparotomy revealed an acute mesenterico-axial gastric volvulus with a left posterolateral diaphragmatic hernia. The stomach volvulus was untwisted, the diaphragmatic defect was repaired after reduction of the herniated contents and no gastropexy was done. At 3 and 6-months follow-up examination the infant was asymptomatic and thriving.
婴儿期急性胃扭转是一种罕见的疾病，也是一种外科急症。对于这种危及生命的情况，及时的临床怀疑和影像学评估至关重要。我们报告一例3个月大的女性病例，最初因怀疑肠梗阻入院。她表现为干呕、呼吸窘迫、上腹部膨隆和嗜睡。无法插入鼻胃管。影像学对比研究显示贲门食管交界处闭塞，钡剂无法通过，有两个胃内液平面，胃呈水平位，占据左半胸下部，提示左侧膈疝。剖腹手术发现急性系膜轴性胃扭转并伴有左后外侧膈疝。扭转的胃被复位，疝内容物回纳后修复膈肌缺损，未进行胃固定术。在3个月和6个月的随访检查中，婴儿无症状且生长良好。
