Endoscopic Features of Paraesophageal Hernia Complicated with Partial Gastric Obstruction: A Case Report

食道旁裂孔赫尼亞併部分胃阻塞的內視鏡診斷－病例報告

莊喬雄(Chiao-Hsiung Chuang) ； 許博翔(Bor-Shyang Sheu) ； 林錫璋(Xi-Zhang Lin)

《慈濟醫學雜誌》 11卷3期 (1999/09) Pp. 285-289

https://doi.org/10.6440/TZUCMJ.199909.0285

摘要

食道裂孔赫尼亞很少被發現併發有部分胃阻塞。我們報告一個這樣的病例。病患因突然嘔吐一些咖啡樣物而到院求診，事前並無任何胃腸道阻塞的症狀。在內視鏡下胃的出口並不容易找到，只在內視鏡反轉時看見扭曲的黏膜皺壁集中到靠近食道胃接合處旁的一個小區域。我們將胃鏡通過此狹窄處，伸入胃遠端與幽門處。因阻塞處在靠近食道胃接口的基底部，在幽門處並無阻塞，故判斷並無胃扭結的現象。因此診斷為食道旁裂孔赫尼亞併部分胃阻塞。這個診斷之後經由上消化道鋇劑攝影確定。病人成功的接受選擇性的手術治療，術後一年追蹤情況良好。

關鍵字

內視鏡 ； 胃阻塞 ； 裂恐赫尼亞 ； 胃扭結

並列摘要

Hiatus hernia is rarely found to be associated with partial gastric obstruction. We here report a patient with this condition. The patient had sudden onset of coffee ground vomitus without any symptoms of gastrointestinal obstruction. Esophagogastroduodenoscopy was performed and only twisted mucosa converging into a point near the esophagogastric junction was noted during retroversion of the endoscope. The endoscope passed the narrowing point and then advanced into the distal stomach and pylorus. No gastric volvulus was noted, because the pylorus was patent and the level of the obstruction was almost as high as the fundus. A diagnosis of paraesophageal hernia with partial gastric obstruction was made. This diagnosis was later confirmed by an upper gastrointestinal series. Elective surgery was performed afterward. The patient remained well one year after surgery.

並列關鍵字

panendoscopy ； gastirc obstruction ； hiatus hernia ； volvulus