Gastric volvulus

胃扭转
  • 文章类型: Case Reports
    胃扭转,以胃旋转为特征,是由先天或后天因素引起的罕见疾病。主要影响儿科和老年人群,为了及时诊断,需要高度怀疑。识别延迟可能会导致严重的并发症,如缺血,勒死,和感染性休克,通常以致命的结果告终。我们介绍一宗个案,一名七十岁男性,最初因怀疑肠胃炎入院,随后在住院期间发展为急性胃扭转,需要立即手术干预。这种情况导致老年人口统计学中关于胃扭转的文献很少。
    Gastric volvulus, characterized by stomach rotation, is a rare condition arising from congenital or acquired factors. Predominantly affecting pediatric and elderly populations, it necessitates a high index of suspicion for timely diagnosis. Delayed recognition may precipitate severe complications such as ischemia, strangulation, and septic shock, often culminating in fatal outcomes. We present a case of a 71-year-old male initially admitted for suspected gastroenteritis, subsequently developing acute gastric volvulus during hospitalization, necessitating immediate surgical intervention. This case contributes to the scant literature on gastric volvulus in the elderly demographic.
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  • 文章类型: Case Reports
    很少报道有机轴胃和乙状结肠扭转并存的病例。在这里我们描述1这样的情况。我们的病人,一个92岁的老人,用柔性乙状结肠镜减压治疗乙状结肠扭转。对于胃扭转,患者最初接受了上内镜胃减压治疗,随后接受了腹腔镜前胃切除术治疗.胃切除术后,病人出现胃出血和缺血,这是一种罕见的并发症,由于胃的血液供应丰富。此病例报告重申有必要考虑患有此类罕见病变的患者的罕见并发症。
    Very few cases of coexisting organoaxial gastric and sigmoid volvuli have been reported. In here we describe 1 such case. Our patient, a 92-year-old man, was treated with a flexible sigmoidoscopy with decompression for his sigmoid volvulus. For the gastric volvulus, the patient was initially treated with an upper endoscopic gastric decompression and subsequently treated with a laparoscopic anterior gastropexy. After the gastropexy, the patient developed bleeding and ischemia of the stomach, which is a rare complication due to the stomach\'s rich blood supply. This case report reiterates the need to consider rare complications in patients with such rare pathologies.
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  • 文章类型: Case Reports
    胃扭转是一种罕见的疾病,其发病率仍然未知。除非医疗保健提供者积极考虑,胃扭转的诊断,这可能导致显著的发病率和死亡率,可能会被忽视。这种情况可以表现为急性或慢性形式,表现出不同的症状。值得注意的是,尽管最初进行了止吐治疗,但食管裂孔疝的存在以及持续的呕吐应引起对胃扭转的怀疑,即使患者临床上表现稳定。急性胃扭转通常通过手术治疗。这里,我们描述了一个老年男性,他被诊断为急性胃扭转,并接受了内窥镜检查的保守治疗。
    Gastric volvulus is a rare condition whose incidence remains largely unknown. Unless actively considered by healthcare providers, the diagnosis of gastric volvulus, which can lead to significant morbidity and mortality, may be overlooked. This condition can manifest in either acute or chronic forms, presenting with diverse symptoms. Notably, the presence of a hiatal hernia alongside persistent vomiting despite initial antiemetic therapy should raise suspicion for gastric volvulus, even if the patient appears clinically stable. Acute gastric volvulus is usually managed surgically. Here, we describe the case of an elderly male who was diagnosed with acute gastric volvulus and was treated conservatively with endoscopy.
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  • 文章类型: Case Reports
    简介:Bochdalek\'s疝(BH)是一种先天性膈疝,主要在儿科人群中诊断,但很少在成人中发现。本文介绍了一名成年患者的独特病例,该患者患有左侧BH并伴有胃扭转和胸内肾。
    一名21岁男性出现腹痛和呕吐。MDCT扫描显示胃扭曲,脾,脾肾脏因左膈膨出而突出进入胸部.手术包括解开胃,重新安置器官,切除疝囊.
    结论:Bochdalek疝(BHs)是罕见的疾病,其中腹部器官由于隔膜缺损而进入胸部。BH通常发生在左侧,可以由怀孕等因素触发,肥胖,或者外伤.症状可能从腹痛到胸部不适,诊断可能具有挑战性。诸如CT扫描之类的成像测试对于准确诊断至关重要。在成年人中,BH可以包含各种器官,如脾脏和肾脏。很少,BH可与位于胸腔内的异位肾相关联。在BH的某些情况下,有并发症的风险,如胃扭转,胃会自己扭曲,导致严重的症状,如严重的腹痛和呕吐。
    结论:该案例强调了成人BH的严重风险,例如胃扭曲和阻塞,需要紧急手术。及时诊断和手术干预对于预防危及生命的结果至关重要。需要更多的研究来改善这种罕见疾病的管理。
    UNASSIGNED: Introduction: Bochdalek\'s hernia (BH) is a congenital diaphragmatic hernia predominantly diagnosed in the pediatric population but infrequently found in adults. This paper presents a unique case of an adult patient with a left-sided BH accompanied by gastric volvulus and an intrathoracic kidney.
    UNASSIGNED: A 21-year-old male presented with abdominal pain and vomiting. An MDCT scan revealed a twisted stomach, spleen, and kidney herniated into the chest due to left diaphragmatic eventration. Surgery involved untwisting the stomach, relocating the organs, and removing the hernia sac.
    CONCLUSIONS: Bochdalek hernias (BHs) are rare conditions in which abdominal organs move into the chest due to defects in the diaphragm. BH usually occurs on the left side and can be triggered by factors such as pregnancy, obesity, or trauma. Symptoms can vary from abdominal pain to chest discomfort, and diagnosis can be challenging. Imaging tests such as CT scans are essential for accurate diagnosis. In adults, the BH can contain various organs, such as the spleen and kidney. Rarely, BH can be associated with an ectopic kidney located inside the chest cavity. In some cases of BH, there is a risk of complications such as gastric volvulus, where the stomach twists on itself, leading to potentially serious symptoms such as severe abdominal pain and vomiting.
    CONCLUSIONS: This case underscores the severe risks of BH in adults, such as gastric twisting and blockage, necessitating urgent surgery. Timely diagnosis and surgical intervention are crucial for preventing life-threatening outcomes. More research is needed to improve the management of this rare condition.
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  • 文章类型: Case Reports
    胃扭转和脾脏游荡是两种罕见且罕见的疾病。胃扭转的特征是胃围绕自身旋转,造成一个封闭的阻塞。它最早是在19世纪描述的,根据轴线分类,病因学,或慢性。脾脏游荡的定义是缺乏一个或所有的脾韧带,这是由于先天或后天原因而发生的。肿大的脾脏可能会导致脾脏游荡,反过来,导致胃扭转和胃梗塞,需要紧急手术干预。在这份报告中,我们介绍了一例19岁的女性,她因严重的腹痛和上腹胀而到急诊科就诊。在进行必要的调查后,她被诊断为脾脏游荡和急性胃扭转。立即进行剖腹手术,切除脾脏和胃,以在正确的时间挽救患者的生命。
    Gastric volvulus and wandering spleen are two rare and uncommon conditions. Gastric volvulus is characterized by the rotation of the stomach around itself, causing a closed obstruction. It was first described in the 19th century and is classified according to the axis, etiology, or chronicity. A wandering spleen is defined by the absence of one or all of the splenic ligaments, which occurs either for congenital or acquired reasons. An enlarged spleen may contribute to the wandering spleen and, in turn, lead to gastric volvulus and infarction of the stomach, requiring emergency surgical intervention. In this report, we present a case of a 19-year-old female who presented to the emergency department with severe abdominal pain and epigastric distension. After performing the necessary investigations, she was diagnosed with a wandering spleen and acute gastric volvulus. An immediate laparotomy was performed and both the spleen and the stomach were resected to save the patient\'s life at the right time.
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  • 文章类型: Case Reports
    我们正在报告一名52岁男子的胃扭转病例,该病例最初是在计算机断层扫描(CT)上发现的食道旁疝。腹部CT显示大的食管旁疝伴远端胃和胃十二指肠交界处的胸内疝,导致与急性胃扭转一致的肠系膜轴旋转。食管胃十二指肠镜检查(EGD)证实存在胃扭转,这最初是由内窥镜矫正造成的。随后,他进行了鼻胃管放置,并最终进行了腹腔镜胃切除术。他计划进行Roux-en-Y胃旁路手术后恢复顺利。
    We are reporting a case of gastric volvulus in a 52-year-old man in the setting of a paraesophageal hernia initially identified on computerized tomography (CT). CT of the abdomen showed a large paraesophageal hernia with intra-thoracic herniation of the distal stomach and gastroduodenal junction, resulting in mesenteroaxial rotation consistent with acute gastric volvulus. Esophagogastroduodenoscopy (EGD) confirmed the presence of the gastric volvulus, which was initially temporized with endoscopic detorsion. He subsequently had nasogastric tube placement and ultimately underwent a laparoscopic gastropexy. He recovered uneventfully with plans for Roux-en-Y gastric bypass surgery.
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  • 文章类型: Case Reports
    胃扭转(GV)是一种罕见的疾病,其特征是胃的全部或部分围绕其横向或纵向轴线旋转。我们报道了一个76岁女性急性GV的病例,食管裂孔疝和年龄相关性韧带松弛可能加剧,在她入院前进化了一周.她接受了中线剖腹手术,并在270°胃底折叠术和前胃切除术。GV在其急性表现中构成危及生命的风险。手术治疗需要恢复血液动力学稳定性,手术扭转,并解决病因(食管裂孔疝)。
    Gastric volvulus (GV) is a rare condition characterized by the rotation of all or part of the stomach around its transversal or longitudinal axis. We report the case of a 76-year-old woman with the acute form of GV, likely exacerbated by hiatal hernia and age-related ligamentous relaxation, evolving for a week before her admission. She underwent a midline laparotomy with fundoplication at 270° and anterior gastropexy. GV poses life-threatening risks in its acute presentation. Surgical management entails restoring the hemodynamic stability, surgical detorsion of the volvulus, and addressing the etiology (hiatal hernia).
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  • 文章类型: Journal Article
    食管裂孔疝是临床实践中常见的。在某些情况下,尤其是在大型食管裂孔疝中,胃扭转可以发生。肠扭转患者通常会出现呕吐,胸痛,呼吸急促,和吞咽困难.在极端情况下,胃扭转可导致胃坏死,需要部分或全部胃切除术。在这里,我们重点介绍了一例76岁的女性,患有已知的大型IV型食管裂孔疝,被发现患有胃扭转伴坏死,需要进行部分袖状胃切除术。这个案例证明了罕见的,但胃坏死可能是由食管裂孔疝引起的胃扭转继发的并发症,促使紧急手术干预。
    Hiatal hernias are commonly encountered in clinical practice. In certain cases, especially in large hiatal hernias, gastric volvulus can occur. Patients with volvulus typically will present with vomiting, chest pain, shortness of breath, and dysphagia. In extreme cases, gastric volvulus can result in gastric necrosis requiring partial or total gastrectomy. Here we highlight a case of a 76-year-old female with a known large type IV hiatal hernia who was found to have gastric volvulus with necrosis requiring partial sleeve gastrectomy. This case demonstrates the rare, but possible complication of gastric necrosis secondary to gastric volvulus from a large hiatal hernia, prompting emergent surgical intervention.
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  • 文章类型: Case Reports
    胃扭转是一种罕见的潜在威胁生命的医疗状况,其特征在于胃或胃的一部分围绕其纵轴或横轴旋转。急性胃扭转通常表现为上腹痛的三联征,非生产性干馏,无法通过鼻胃管。通过腹部和胸部X线检查以及对比研究辅助诊断。
    方法:一名53岁女性出现持续两天的腹痛,开始于上腹部区域,后来在整个腹部扩散。她伴有频繁的呕吐发作,最初是胆汁性的,随后是非生产性干馏和低度间歇性发热。腹部检查显示扩张,腹部弥漫性触痛,上腹部肿块不明确。腹部X线显示腹部中央圆形混浊,与胃轮廓连续。术中发现坏疽性肠轴胃扭转穿孔,脾胰腺扭转伴脾脏游走。行近端胃大部切除术伴食管胃吻合和脾切除术。患者在术后第10天出院,术后恢复顺利。
    原发性胃扭转通常是肠系膜轴,幽门通常向前旋转。原发性胃扭转可能与先天性脾和脾脏游走有关,因为这两种情况的特征都是韧带附着缺失或松弛。该病例是中肠轴扭转伴脾胰腺扭转,由异常韧带附着引起的脾脏游走。
    结论:需要高度怀疑胃扭转的早期诊断和及时干预以改善治疗结果。
    UNASSIGNED: Gastric volvulus is an uncommon potentially life-threatening medical condition characterized by rotation of the stomach or part of the stomach around its longitudinal or transverse axis. Acute gastric volvulus usually presents with the triads of epigastric pain, nonproductive retching, and inability to pass the nasogastric tube. Diagnosis is assisted with abdominal and chest x-ray and contrast studies.
    METHODS: A 53-year-old female presented with abdominal pain of two days duration which started at the epigastric region and later on became diffuse all over the abdomen. She had associated frequent episodes of vomiting which were initially bilious followed by nonproductive retching and low-grade intermittent fever. Abdominal examination showed a distended, diffusely tender abdomen with an ill-defined epigastric mass. Abdominal X-ray showed central abdominal circular opacity continuous with stomach outline. Intraoperative findings revealed perforated gangrenous mesenteroaxial gastric volvulus and splenopancreatic torsion with wandering spleen. Proximal subtotal gastrectomy with esophagogastric anastomosis and splenopexy was performed. The patient was discharged on the 10th postoperative day and had an uneventful post-operative recovery.
    UNASSIGNED: Primary gastric volvulus is usually mesenteroaxial with the pylorus commonly rotating anteriorly. Primary gastric volvulus can be associated with congenital asplenia and wandering spleen as both conditions are characterized by absent or loose ligamentous attachments. This case was a mesenteroaxial volvulus with splenopancreatic torsion with a wandering spleen caused by abnormal ligamentous attachments.
    CONCLUSIONS: A high index of suspicion for early diagnosis of gastric volvulus and timely intervention is required to improve treatment outcome.
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  • 文章类型: Case Reports
    导致急性胃扩张的胃扭转是先天性膈疝的罕见表现。紧急的牵拉和胃扩张和膈肌缺损的闭合对于防止进一步的并发症和复发至关重要。我们介绍了一例罕见的婴儿,由于先天性膈疝继发的急性胃扭转而导致急性胃扩张。
    Gastric volvulus leading to acute gastric dilatation is a rare presentation of congenital diaphragmatic hernia. Urgent detorsion with gastropexy and closure of the diaphragmatic defect are essential to prevent further complications and recurrence. We present a rare case of an infant with acute gastric dilatation due to acute gastric volvulus secondary to congenital diaphragmatic hernia.
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