Recurrent valvular pneumoperitoneum caused by a minute gastric ulcer--a case report.

S Imabun, M Miyata, Y Tanaka, T Hashimoto, T Yamaguchi, S Sunada, T Kitagawa, Y Kawashima
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引用次数: 4

Abstract

A rare case of valvular pneumoperitoneum is reported. A 49-year-old Japanese man underwent an emergency laparotomy under a tentative diagnosis of perforating panperitonitis on the 19th post-open heart surgery day. A large volume of free intraperitoneal gas was revealed, but no identification of gastrointestinal perforation. On the 17th postlaparotomy day, pneumoperitoneum recurred. On the 41st postlaparotomy day, a tiny gastric perforation was detected with an oral contrast medium. The patient died of liver failure due to serum hepatitis. The autopsy revealed a minute gastric ulcer scar 2 mm in diameter in the mucosa of the fornix, which was thought to have caused the valvular pneumoperitoneum. A literature review was made of 8 reports on 11 cases. In two cases of valvular pneumoperitoneum, the perforating site could not be found even during laparotomy. It is suggested that either gastrointestinal series or endoscopy must be carefully repeated in order to identify the perforating site.

一分钟胃溃疡致复发性瓣膜性气腹1例。
本文报告一例罕见的瓣膜性气腹。一名49岁的日本男性在心脏直视手术后第19天接受了紧急剖腹手术,初步诊断为穿孔性腹膜炎。腹腔内有大量游离气体,但未见胃肠道穿孔。术后第17天气腹复发。剖腹后第41天,口服造影剂检测到一微小的胃穿孔。病人死于血清性肝炎引起的肝功能衰竭。尸检发现穹窿粘膜处有直径2mm的微小胃溃疡疤痕,认为是瓣膜性气腹的原因。对11例病例的8篇报道进行文献复习。在两例瓣膜性气腹中,即使剖腹手术也无法找到穿孔部位。建议胃肠道系列或内镜检查必须仔细重复,以确定穿孔部位。
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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