3세 소아에서 발생한 Gastric Volvulus 1례
A Case of Gastric Volvulus in a 3-year-old Female
이진태, 김한선, 차한, 박호진, 김화중, 김희섭,
소속 상세정보
이진태 ( Lee Jin-Tae )
서울 적십자병원 소아과
김한선 ( Kim Han-Sun )
서울적십자병원 일반외과
차한 ( Tchah Hann )
서울 적십자병원 소아과
박호진 ( Park Ho-jin )
서울 적십자병원 소아과
김화중 ( Kim Hwa-Jung )
서울 적십자병원 소아과
김희섭 ( Kim Hee-Sup )
서울 적십자병원 소아과
KMID : 0816120000030010089
Abstract
위 염전증은 소아에서 드물지만 응급을 요하는 질환으로 최근 비사출성, 비담즙성 구토를
주소로 내원한 3세 환아에서 시험하였기에 문헌 고찰과 함께 보고하는 바이다
Acute gastric volvulus is uncommon but surgically emergent.
Normally, the stomach is held in position by four ligaments: gastrophrenic,
gastrohepatic, gastrosplenic, and gastrocolic. In addition, relative fixation of the pylorus
and esophagus provides further anchorage. A normal diaphragm also helps to prevent
abnormal displacement of abdominal viscera and development of gastric volvulus.
Volvulus may be organoaxial, mesenteroaxial, or a combination of both. Organoaxial
volvulus is the rotation of the stomach around an axis extending from the hiatus of the
diaphragm to the pylorus. Mesenteroaxial volvulus is the rotation of the stomach around
an axis transecting the lesser and greater curvatures of the stomach. The symptoms of
gastric volvulus depend on its type, the extent and degree of rotation and obstruction,
and associated defects. Classic clinical features of acute gastric volvulus, as by
Borchardt in 1904, include unproductive retching, acute, localized epigastric distention,
and the inability to pass a NG tube. The Presence and severity of these features depend
on the degree of gastric obstruction of both the gastroesophageal junction and pyloric
outlet.
It may be suspected on plain abdominal radiographs and usually confirmed by upper
gastrointestinal series. Acute volvulus requires immediate surgical repair, fixation to
avoid recurrence, and correction of any underlying anatomic abnormality. Any associate
defect should be repaired and the stomach must be fixed.
The authors report a case of an 3-year-old girl who had a mesenterioaxial gastric
volvulus.
키워드
Gastric Volvulus; Child;
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