小児胃捻転症に於ける捻転様式について : 捻転軸に対する再検討

概要

論文の詳細を見る
The organo-axial and mesentero-axial classification of gastric volvulus has been accepted since proposed by Kocher in 1914. However, by analysing two cases of idiopathic gaslric volvulus which were successfully treated (one opcratively anather nonoperatively), we faced a difficulty to explain the sequence of gastric volvulus by the conventional organo-axial and mesentero-axial theory. The conventional classiffication which divides gastric volvulus into two patterns (organo-axial and mesenlero-axial volvulus) does not fit in many cases. The pure organo-axial type and mesentcro-axial type are rather of exception. And it should be emphasised that the axis itself is changing in the sequence of the volvulus. We speculate that the axis at the gastric volvulus moves from the more-organoaxial direction to more-mesenteroaxial direction as volvulus progress. Since the stomach is loosely or not fixed at the greater curvature, fundus and pyloric region, the greater curvature is lifted up or pulled up ventrally and cranially and sometimes toward lesser curvature. The fundus moves dorsally and caudally, and the stomach will finally become up side down. In some situation, the fundus may move doraslly and caudally prior to lifting of the greater curvature.
日本小児外科学会の論文
1980-10-20