PDF(Pubmed)
Abstract：
Gastric volvulus is an uncommon clinical condition with the potentially life-threatening complication of acute gastric necrosis. A wandering spleen may also be associated with gastric volvulus and can produce a diagnostic dilemma as the cause of an acute abdomen. We present a case of an elderly woman who presented with acute abdominal symptoms. She did not have the classical Borchardt triad to diagnose gastric volvulus and had a coexisting wandering spleen. Although torsion and ischemia of the wandering spleen were initially thought to be the cause of acute abdomen, a subsequent contrast-enhanced CT (CECT) scan confirmed a coexistent mesenteric-axial gastric volvulus with gangrenous changes. We present this case to highlight a rare combination of pathologies, either of which can confuse the diagnosis or cause a delay in management. Early diagnosis with CECT is emphasized, and segmental resection is feasible when the rest of the viscus can be preserved.
摘要：
胃扭转是一种罕见的临床疾病，具有潜在的危及生命的急性胃坏死并发症。脾脏游走也可能与胃扭转有关，并可能导致急腹症的诊断困境。我们介绍了一例出现急性腹部症状的老年妇女。她没有经典的Borchardt三联组来诊断胃扭转，并且有一个共存的游走脾脏。尽管最初认为游离脾脏的扭转和缺血是急腹症的原因，随后的对比增强CT（CECT）扫描证实肠系膜-轴性胃扭转并存，并伴有坏疽性改变。我们提出这个案例是为了强调一种罕见的病理组合，其中任何一种都可能混淆诊断或导致管理延迟。强调CECT的早期诊断，当内脏的其余部分可以保存时，分段切除是可行的。
