胃扭转的诊断和治疗：附30例报告

目的:探讨胃扭转的发病机制、诊断及治疗。方法:回顾性分析30例胃扭转的临床资料。结果:术前确诊17例(56.7%），手术中确诊13例(43.3%）。诊断为纵轴型21例（70.0％），横轴型8例（26.7％），混合轴型1例（3.3％）。3例行内镜下复位，27例接受手术治疗。30例均康复出院，全组病例均随访5年,内镜下复位后复发1例，余病例无复发。结论:胃扭转主要由胃周支持韧带松弛引起，发病由多因素共同作用所致。诊断依据临床表现和影像学检查综合分析或手术探查，治疗首选手术。

Diagnosis and treatment of gastric volvulus: a report of 30 cases

Objective To investigate the pathogenesis, diagnosis and treatment of gastric volvulus. Methods The clinical data of 30 patients with gastric volvulus were analyzed retrospectively. Results 17 patients(56.7%) were diagnosed preoperatively,and 13 patients(43.3%) at exploratory laparotomy. 21 cases(70.0%) was diagnosed as organo-axial type, 8 cases(26.7%) as mesenterico-axial type, and 1 case((3.3%)) as combined type.3 patients underwent gastric volvulus restoration by endoscopy;27 patients (received) operation,and all the 30 patients were discharged in good health.All of the cases were followed up for 5 years;one case,treated by endoscopy,recurred,but none of the other cases recurred. Conclusions Laxity of gastric suspensory ligaments is the main pathogenetic factor of gastric volvulus,but its occurrence is usually caused by multiple factors.The diagnosis depends on the combined analysis of the clinical (manifestations) and radiographic studies or exploratory laparotomy. Operation is the first choice of treatment.