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急性胃扩张可以在多种情况下发生,但70％的病例是继发于腹腔术后,暴饮暴食可致急性胃扩张,但属罕见,今遇1例,报告如下: 王某,64岁,素日健康,某日晚餐进食水饺1斤,次晨上腹不适,胀满,未予诊治,仍正常进餐,上腹疼痛和腹胀继续加剧,于第三日住院求治。患者表情痛苦,脉搏速弱,呼吸浅而快,皮肤冷,有虚汗。查体;全腹膨隆,叩诊实音、轻度压痛、无肌紧张和反跳痛,肠音减弱,X线示膈肌升高,胃高度扩张,确诊为急性胃扩张。即施胃肠减压为主综合非手术治疗,但胃管减压微量,腹胀不减,因效果不佳而改手术检查。胃高度膨胀达盆腔,切开胃前壁,胃内被1500ml食糜占据,清除后查腹腔未见异常,术后经过顺利,患者随访2年健康。
Acute gastric distension can occur in a variety of circumstances, but 70% of cases are secondary to abdominal surgery, overeating can cause acute stomach distension, but it is rare, now a case, the report is as follows: Wang, 64 years old , A vegetarian day, a day dinner dumplings 1 kg, the next morning abdominal discomfort, fullness, no diagnosis and treatment, still normal eating, abdominal pain and bloating continue to aggravate, on the third day hospitalized. Patient expression pain, weak pulse, breathing shallow and fast, cold skin, there is sweating. Examination; full abdominal bulge, percussion real note, mild tenderness, no muscle tension and rebound tenderness, intestinal sound weakened, X-ray showed elevated diaphragm, a high degree of expansion of the stomach, diagnosed as acute stomach dilatation. The main application of gastrointestinal decompression comprehensive non-surgical treatment, but the trace of gastric tube decompression, abdominal distension does not diminish due to poor performance and change the operation check. Stomach height expansion of the pelvis, anterior gastric wall incision, the stomach was 1500ml of constipation occupy, check the abdomen clear no abnormalities after surgery, the patient was followed up for 2 years health.