经皮内镜胃造口术饲管移位致胃十二指肠顺行肠套叠一例。

Abdelwahap Elghezewi, Mohamed Hammad, Mujtaba Mohamed, Peter Chirico, Wesam Frandah
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摘要

胃十二指肠肠套叠是一种胃突出到十二指肠的危重症状。这是一种非常罕见的成人疾病。最常见的原因包括胃腔内病变,包括胃的良性或恶性肿瘤。最常见的肿瘤包括胃肠道间质瘤(gist)、胃癌、胃脂肪瘤、胃平滑肌瘤和胃神经鞘瘤。由经皮饲管移位引起的病例极为罕见。50岁女性,经皮内镜胃造口术(PEG)插管后有吞咽困难病史,有痉挛性四肢瘫痪病史,表现为急性恶心、呕吐和腹胀,CT扫描发现胃十二指肠肠套叠。拔置PEG管后,情况得到解决。内镜检查未发现任何腔内病变。使用Avanos Saf-T-Pexy t型紧固件进行外固定以防止复发。胃十二指肠肠套叠最常见的原因是胃肠道间质瘤。腹部CT是最准确的检查,需要上腔镜检查以排除任何腔内原因。治疗的选择是内镜或手术切除。外固定对于预防复发是必不可少的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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A Rare Case of Anterograde Gastroduodenal Intussusception Caused by Migrated Percutaneous Endoscopic Gastrostomy Feeding Tube.

Gastroduodenal intussusception is a critical condition in which stomach protrudes into the duodenum. It is a very rare condition in adults. Most common causes include intra luminal lesions in the stomach including benign or malignant tumors of the stomach. Most common tumors included are gastrointestinal stromal tumors (GISTs), gastric carcinoma, gastric lipoma, gastric leiomyoma, and gastric schwannoma. It is extremely rare to be caused by migration of percutaneous feeding tube. A 50-year-old woman with a past medical history (PMH) of dysphagia status post percutaneous endoscopic gastrostomy (PEG) tube, history of spastic quadriplegia, presented with acute nausea, vomiting and abdominal distention, and was found to have gastroduodenal intussusception in computed tomography (CT) scan. Condition resolved after retracting PEG tube. Endoscopy did not reveal any intra luminal lesions. External fixation using Avanos Saf-T-Pexy T-fasteners was performed to prevent recurrence of this condition. Most common of causes of gastroduodenal intussusception are GIST tumors of stomach. CT abdomen is the most accurate test and upper endoscopy is needed to rule out any intra luminal causes. Treatment of choice is either endoscopic or surgical resection. External fixation is essential to prevent recurrence.

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