先天性食管裂孔疝所致胸腔胃误诊为先天性短食管致胸腔胃

Intrathoracic Stomach Secondary to Congenital Hiatal Hernia Misdiagnosed as Intrathoracic Stomach Secondary to Congenital Short Esophagus

目的探讨先天性食管裂孔疝(congenital hiatus hernia,CHH)所致胸腔胃的鉴别诊断要点及外科治疗措施。方法对我院收治的1例CHH所致胸腔胃误诊为先天性短食管致胸腔胃的临床资料进行回顾性分析。结果本例术前依据胸部CT及钡餐影像学检查误诊为先天性短食管并完全型右胸腔胃,后经开胸探查确诊为CHH并完全型右胸腔胃,行胸腔胃还纳并膈食管裂孔修补术。术后恢复良好,无并发症。随访2年无复发。结论 CHH所致胸腔胃易误诊为先天性短食管致胸腔胃,手术探查可明确诊断。CHH所致胸腔胃患者手术治疗预后良好。

Objective To probe the main points of differential diagnosis and surgical treatment of intrathoracic stomach secondary to congenital hiatal hernia（CHH）.Methods The clinical date of the case with intrathoracic stomach secondary to CHH misdiagnosed as intrathoracic stomach secondary to congenital short esophagus was retrospectively analyzed.Results According to the chest CT scanning and barium meal,the patient was misdiagnosed as having congenital short esophagus before the operation.The diagnosis of intrathoracic stomach secondary to CHH was confirmed by the operational research.Surgical repair included reduction of the stomach and repair of the diaphragm.The patient recovered well after operation without complications.A 2 years follow-up survey showed that patient was in a good condition without recurrence.Conclusion Intrathoracic stomach secondary to CHH may be easily misdiagnosed as intrathoracic stomach secondary to congenital short esophagus.Surgical research helps to make the accurate diagnosis.Patient with intrathoracic stomach secondary to CHH may have satificatory prognosis after surgical repair.