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- Gastric Volvulus: Report of Six Cases
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題名 | Gastric Volvulus: Report of Six Cases=胃扭結:六病例報告 |
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作者 | 胡詔凱; 陳俊欽; 徐以信; 陳瑞灝; 孫灼基; 楊國卿; | 書刊名 | 中華民國消化系醫學雜誌 |
卷期 | 14:4 1997.12[民86.12] |
頁次 | 頁41-47 |
分類號 | 415.52 |
關鍵詞 | 胃扭結; 傍食道疝氣; Gastric volvulus; Paraesophageal hernia; |
語文 | 英文(English) |
中文摘要 | 對於今日的胃腸科專家而言,胃扭結是一種罕見的疾病。本院自一九九三年至一九九七年止,共發現有六例患者。其中五例出現上腹痛、四例有嘔吐、二例合併上消化道出血,一例以非胃扭結相關症狀而被意外發現。臨床初步診斷以消化性潰瘍或上消化道出血居多。 沒有任何病例是一開始就被診斷為胃扭結。分類上而言: 二例為腸系膜軸型(mesenteroaxial) 四例為器官軸型(organoaxial)。 在誘發因素方面:二例有傍食道疝氣,一例曾接受胃部手術,四例年齡≧ 65 歲,一例有胃潰瘍。在治療方面,二例急性患者皆接受手術且癒後良好。三例慢性患者則因不等程度上腹痛接受內科治療。其中二例在禁食及藥物治療後無復發現象;另一例則有輕微上腹部不適感。結論:對於急性腹症者或模糊性胃腸不適者,均應將胃扭結列入鑑別診斷。了解胃扭結的臨床症狀及誘發原因,不僅有功於早期診斷且可選擇適當的治療方式包括緊急手術。 |
英文摘要 | Gastric volvulus is a rare condition existing to the gastroenterologist today. We reviewed six cases of gastric volvulus in our hospital between 1993 and 1997. Of these six cases, five had bouts of severe epigastric pain, four patients had unproducting vomiting, and two patients had UGI bleeding. Only one case was found incidentally without any volvulus-related symptoms. Peptic ulcer disease and UGI bleeding were the common initial presumptive impressions. In none of the patients was the condition clinically suspected. In type of gastric volvulus, two patients were mesenteroaxial and four were organoaxial. In the study of predisposing factors, paraesophageal hernia, previous surgery of stomach, an age of over 65 years, and gastric ulcer were noted. In treatment, surgical intervention for 2 cases with acute gastric volvulus achieved good results. Three chronic cases sustained occasional bouts of epigastralgia, varying in severity. Two of them had no symptoms during the follow-up period after naso gastric tube decompression and medical treatment. One patient sustained vague epigastric pain with evidence of gastric volvulus within 12 months of follow-up. In conclusion, gastric volvulus must be considered in the differential diagnosis of acute abdomen or other vague GI complaints as its presentation may be subtle. An understanding of the varied clinical features and predisposing factors is essential to early recognition, and adequate treatment selection includes emergent surgery. |
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