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首页> 美国卫生研究院文献>Case Reports in Gastroenterology >Recurrent Upside-Down Stomach after Endoscopic Repositioning and Gastropexy Treated by Laparoscopic Surgery
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Recurrent Upside-Down Stomach after Endoscopic Repositioning and Gastropexy Treated by Laparoscopic Surgery

机译：腹腔镜手术治疗内窥镜复位和胃下垂术后复发性倒胃

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Patients with an upside-down stomach usually receive surgical treatment. In high-risk patients, endoscopic repositioning and gastropexy can be performed. However, the risk of recurrence after endoscopic treatment is not known. We treated a case of recurrent upside-down stomach after endoscopic therapy that indicated the limits of endoscopic treatment and risk of recurrence. An 88-year-old woman was treated three times for vomiting in the past. She presented to our hospital with periodic vomiting and an inability to eat, and a diagnosis of upside-down stomach was made. Endoscopic repositioning and gastropexy were performed. The anterior stomach wall was fixed to the abdominal wall in three places as widely as possible. Following treatment, she became symptom-free. Three months later, she was hospitalized again because of a recurrent upside-down stomach. Laparoscopic repair of hernias and gastropexy was performed. Using a laparoscope, two causes of recurrence were found. One cause was that the range of adherence between the stomach and the abdominal wall was narrow (from the antrum only to the lower corpus of stomach), so the upper corpus of stomach was rotated and herniated into the esophageal hiatus. The other cause was adhesion between the omentum and the esophageal hiatus which caused the stomach to rotate and repeatedly become herniated. Although endoscopic treatment for upside-down stomach can be a useful alternative method in high-risk patients, its ability to prevent recurrence is limited. Moreover, a repeated case caused by adhesions has risks of recurrence.
机译：胃部倒置的患者通常接受手术治疗。在高危患者中，可以进行内窥镜重定位和胃切除术。但是，内镜治疗后复发的风险尚不清楚。我们在内镜治疗后对一例反复倒置的胃进行了治疗，这表明内镜治疗的局限性和复发风险。一名88岁的女性过去曾因呕吐接受过3次治疗。她因周期性呕吐和无法进食而到我们医院就诊，并做出了胃倒置的诊断。进行内窥镜重定位和胃切除术。胃前壁在三个地方尽可能固定在腹壁上。治疗后，她没有症状。三个月后，由于胃部反复倒置，她再次住院。进行腹腔镜疝气修补术和胃切除术。使用腹腔镜检查发现了两个复发原因。原因之一是胃和腹壁之间的粘连范围狭窄（从胃窦到胃下体），因此胃上体旋转并突出到食管裂孔。另一个原因是大网膜与食管裂孔之间的粘连，导致胃旋转并反复突出。尽管对于高危患者，内窥镜倒置胃治疗可能是一种有用的替代方法，但其预防复发的能力有限。此外，由粘连引起的重复病例有复发的风险。

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