混合型食管裂孔疝伴胃扭转1例  

A case of mixed hiatal hernia with gastric torsion

作　　者：王安强 王春芽 王凯旋 毕青美 邱凤娇 张红梅[2] WANG Anqiang;WANG Chunya;WANG Kairuan;BI Qingmei;QIU Fengjiao;ZHANG Hongmei(Weifang Medical University,Weifang,Shandong,261042,China;Department of Gastroenterology,Affiliated Hospital of Weifang Medical University)

机构地区：[1]潍坊医学院,山东潍坊261042 [2]潍坊医学院附属医院消化内二科

出　　处：《中国中西医结合消化杂志》2023年第5期381-383,共3页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

摘　　要：食管裂孔疝多见于中老年人,女性多于男性,主要原因是膈肌裂孔周围韧带结构弹性降低或慢性疾病使胃内压力长期升高所致。长期的酸暴露会使食管痉挛、缩短,导致食管轴向压力增加进而诱发食管裂孔疝。其中滑动型食管裂孔疝最常见,而混合型食管裂孔疝最少见。本文报道1例混合型食管裂孔疝伴胃扭转病例,患者胃食管结合部、胃底、贲门、部分胃体均已疝入胸腔。由于疝入的内容物较多,出现胃扭转和肺不张,行腹腔镜下食管裂孔疝修补术、膈疝修补术、胃底折叠术、网膜粘连松解术,手术顺利,患者术后恢复可。Hiatal hernia mainly occurs in the elderly, and the female is more than the male, it is mainly due to the decrease of the structural elasticity of the ligament around the diaphragmatic hiatus or the long-term increase of gastric pressure caused by chronic diseases. And long-term acid exposure will make the esophagus spasm, shorten, resulting in increased esophageal axial pressure and then induce esophageal hiatal hernia. One of the most common types of hiatal hernia is sliding hiatal hernia, mixed hiatal hernia is the most rarely seen. The paper reports a patient with mixed hiatal hernia and gastric torsion, the patient is characterized by gastroesophageal junction、stomach bottom、cardia、a portion of gastric body sliding into thoracic cavity. The mixed hiatal hernia also leads to gastric torsion and lung atrophy, Laparoscopic esophageal hiatal hernia repair, diaphragmatic hernia repair, fundofolding, and omental adhesion release were performed. The operation was smooth, and the patient recovered after surgery.

关 键 词：食管裂孔疝 食管裂孔疝修补术 胃扭转 胃镜 

分 类 号：R655.4[医药卫生—外科学]