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題名 | Experience with Gastric Volvulus in Pediatric Patients=小兒胃扭結之治療經驗 |
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作者 | 賴勁堯; 許錦城; 張北葉; 王念陸; 陳秋江; 黃富源; 洪漢陽; 許瓊心; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 29:3 民85.05-06 |
頁次 | 頁213-219 |
分類號 | 417.6242 |
關鍵詞 | 小兒; 胃扭結; Gastric volvulus; Gastropexy; |
語文 | 英文(English) |
中文摘要 | 胃扭結是少見的小兒腸胃道阻塞的原因之一。從1984年3月到I995年4 月,一共有十例胃扭結病人在馬偕醫院小兒外科接受治療。全部都是女性。主要 的症狀為腹脹(70)及嘔吐(50)-長軸型扭結佔70,短軸型扭結佔20,而混合型扭結 佔I0。在混合型扭結的病人,士消化道攝影證實了長軸型扭結與短軸型扭結可以 互相轉變。所有的病人再依入院年齡分為兩組:第一組(七例)為入院年齡小於一歲 的新生兒及嬰兒;第二組(三例)為入院年齡大於一歲的兒童。兩組在症狀上並無差 別,但是第二組的症狀較嚴重也較為多樣化。第一組保守治療的成功率達75,優 於第二組的33。第二組有一例患者術中已發現有胃破裂。我們的結論是:小兒胃 扭結比預期中來得多。當患者有腹脹與嘔吐時,胃扭結應為重要的鑑別診斷之 一。一般以長軸型胃扭結較多見,但長軸型胃扭結與短軸型胃扭結可以互變。治 療胃扭結時,患特異性胃扭結的新生兒與嬰兒應先考慮保守治療;手術則保留給 大於一歲的兒童與保守治療無效的新生兒及嬰兒。前胃固定術則為一安全而簡單 的手術方法。 |
英文摘要 | Gastric volvulus is a rare cause of gastrointestinal obstruction in pediatricpatients. From March, 1984 to April, 1995, ten pediatric patients with gastric volvulus were treated at this institution. All were females. The mainsyrntoms were abdominal distension (70) and vomiting (50). There were70 of the organoaxial type, 20 of the mesenteroaxial type, and 10, ofthe type. In the patient of mixed type, interchangeability of mesenterozxialand organoaxial type volvulus was proved by an upper gastrointestinalseries. The patients were further divided into two groups according to ageat-admission: Group I (n=7): patients under one year old and Group II (n=3):over one year of age. There was no symptom difference between the twogroups, but the symptoms in Group II was more severe and varied. Thesuccess rate with conservative treatment was 75 in Group I and 33 inGroup II. One patient in Group II developed gastric perforation during surgery. In conclusion, pediatric gastric volvulus is not so rare as believed. Itshould be considered as one of the important disorders in the differentialdiagnosis of patients with abdominal distension and vomiting. Organoaxialvolvulus is more common than mesenteroaxial volvulus, but the type ofgastric volvulus might be interchangeable. When managing patients withgastric volvulus, conservative treatment is the treatment-of-choice inneonates and infants with idiopathic gastric volvulus. Operation is indicatedin children over one year old, and in neonates and infants who do not respond to conservative treatment. Anterior gastropexy is a simple and safeprocedure. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。