| 作者 |
Jin-Yao Lai, Jin-Cherng Sheu, Pei-Yeh Chang, Nien-Lu Wang, Chiu-Chiang Chen, Fu-Yuan Huang, Han-Yang Hung, Chyong-Hsin Hsu |
| 摘要 |
Gastric volvulus is a rare cause of gastrointestinal obstruction in pediatric
patients. From March, 1984 to April, 1995, ten pediatric patients with gastric
volvulus were treated at this institution. All were females. The main symtoms were abdominal d.istension (70%) and vomiting (50%). There were 70% of the organoaxial type, 20% of the mesenteroaxial type, and 10%, of the type. In the patient of mixed type, interchangeability of mesenterozxial and organoaxial type volvulus was proved by an upper gastrointestinal series. 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 two groups, but the symptoms in Group II was more severe and varied. The success rate with conservative treatment was 75% in Group I and 33% in Group II. One patient in Group II developed gastric perforation during surgery.In conclusion, pediatric gastric volvulus is not so rare as believed. It should be considered as one of the important disorders in the differential diagnosis of patients with abdominal distension and vomiting. Organoaxial volvulus is more common than mesenteroaxial volvulus, but the type of gastric volvulus might be interchangeable. When managing patients with gastric volvulus, conservative treatment is the treatment-of-choice in neonates and infants with idiopathic gastric volvulus. Operation is indicated in children over one year old, and in neonates and infants who do not respond to conservative treatment. Anterior g.. a stropexy is a simple and safe procedure. |
