未消化的蒜瓣致胃出口梗阻1例

Anthony Bedran , Ryan Akl , Karam Karam , Elias Fiani , Ihab I. El Hajj
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摘要

高血压是一个广泛的全球健康问题,饮食调整是一个重要的非药物治疗方法。增加食用富含纤维的食物,如水果、蔬菜和大蒜,已被证明可以降低血压,改善心血管健康。人们食用大蒜的好处包括控制高血压。很少情况下,过量摄入这些食物会导致胃肠道并发症,包括形成植物粪黄,这是一种难以消化的植物物质,可能会导致严重的阻塞。胃出口梗阻的病例中,有0.4-4 %是由牛黄引起的。虽然罕见,但这些阻塞可导致恶心、呕吐和腹痛等症状,可能需要手术干预。在没有治疗的情况下,滞留在胃肠道的牛黄与死亡率高达30% %有关。本病例报告提出一名59岁女性,既往高血压控制不佳,尽管增加降压药剂量,其血压仍保持在180/100 mmHg的高位。为了控制自己的病情,她吃了一瓣大蒜瓣,没有咀嚼,作为膳食补充剂。随后,她以两天的上腹部疼痛、持续恶心和进食后呕吐就诊于急诊科。影像学(包括普通CT扫描)显示胃充满液体,幽门处有一个2 厘米的不规则致密肿块,提示植物粪黄。胃镜检查证实幽门前区存在一个大的未消化的蒜瓣,使用罗斯网成功地将其移除。幽门区域显示轻度炎症的迹象,幽门通道的直径小于蒜瓣。患者病情稳定出院。本病例强调了食用未咀嚼食物(如蒜瓣)的潜在胃肠道风险,并强调了高血压患者仔细饮食管理的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
An undigested garlic clove induced gastric outlet obstruction: A case report
Hypertension is a widespread global health issue, and dietary modifications are an important nonpharmacologic approach to its management. Increasing the consumption of fiber-rich foods, such as fruits, vegetables, and garlic, has been shown to reduce blood pressure and improve cardiovascular health. People consume garlic for proposed benefits, including management of hypertension. Rarely, excessive intake of these foods can lead to gastrointestinal complications, including the formation of phytobezoar, masses of indigestible plant material that may cause severe obstructions. Bezoars are responsible for 0.4–4 % of cases of gastric outlet obstruction. Although rare, these obstructions can result in symptoms like nausea, vomiting, and abdominal pain, and may require surgical intervention. In the absence of treatment, lodged bezoars in the gastrointestinal tract have been associated with mortality rates as high as 30 %. This case report presents a 59-year-old woman with a history of poorly controlled hypertension, whose blood pressure remained high at 180/100 mmHg despite increased doses of antihypertensive medication. In an attempt to manage her condition, she ingested a large garlic clove, unchewed, as a dietary supplement. She subsequently presented to the emergency department with two days of epigastric pain, persistent nausea, and vomiting after eating. Imaging, including an unenhanced CT scan, revealed a fluid-filled stomach with a 2 cm irregular dense mass at the gastric pylorus, suggesting a phytobezoar. Gastroscopy confirmed the presence of a large, undigested garlic clove in the pre-pyloric region, which was successfully removed using a Roth net. The pyloric area showed signs of mild inflammation, with the diameter of the pyloric channel smaller than the garlic clove. The patient was discharged in stable condition. This case highlights the potential gastrointestinal risks of consumption of unchewed foods, such as a garlic clove, and emphasizes the importance of careful dietary management in patients with hypertension.
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